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ZONING PERMIT APPLICATION www.countyofdane.com 7:2=1=2:1:11. <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Arboretum East LLC ❑ Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction;CSM <br /> 2524 Todd Drive Madison WI 53713 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> 608-298-0855 ❑ Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Sheila Williams Capital City Neon Sign co. , Inc. ❑ Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 2714 Industrial Drive 2714 Industrial Drive <br /> (City,State,Zip) (City,State,Zip) ❑ Setbacks <br /> Madison WI 53713 Madison WI 53713 <br /> PHONE PHONE ❑ Site Plan approval from <br /> 608-222-1881 608-222-1881 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ccsigns@sbcglobal.net ccsigns@sbcglobal.net Li Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.usn <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑ Elevation of property <br /> ❑ PARCEL frontage drawn to scale. <br /> NUMBER 032/0709-343-2323-0 <br /> TOWNSHIP: SECTION: <br /> 07N09E 34 /a: SW 1/1/: NW ❑ Driveway permits <br /> ADDRESS: (state,county,town) <br /> 2,524 Todd Dr Madison WI 53713 ❑ Sanitary permits <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> 3 Johannsen Plat Lot 3 (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Building sign installation ❑ Zoning District <br /> ❑This project is a new building or structure. Li Permitted Use? <br /> J This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> SEWER ❑SEPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> ❑ Wetland/Floodplainl <br /> Shoreland (attachment) <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: t ST FLOOR: <br /> ❑ ErosionControl permit <br /> 4, TOTAL SQUARE FOOTAGE: ,, (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> Li Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: --► ♦ ♦ - ♦ and available options. <br /> (Please round to nearest dollar) 2100 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or :ke? ..... ❑Yes ❑No ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? <br /> R ❑Yes ❑No ❑Don't know <br /> 3. Have you talked with the township about your project and are they in .greement? ..\ CI Yes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes ❑No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appe. I# ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) ❑Yes ❑No ❑Don't know <br /> 7. Is this to correct a violation? ❑Yes ❑No <br /> APPLICATION i, - - :E SIGNED <br /> 545-112(4/08) on e on Back) —► <br /> VJcJL 2Lig02--- <br /> .„ <br />