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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME <br /> Wolf Paving Company <br /> El Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 5423 Reiner Road,Sun Prairie,WI 53590 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (414)333-6584 seanw @wolfpaving.com ❑Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Jaime Dieman,Innovative Signs Innvoative Signs ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 21795 Doral Rd,Ste B 21795 Doral Rd,Ste B <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Waukesha,WI 53186 Waukesha,WI 53186 <br /> PHONE PHONE <br /> ❑Site Plan approval from <br /> (262) 432-1330 (262) 432-1330 applicable township. <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> jaime @innovative-signs.com jaime @innovative-signs.com ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: ❑Elevation of property <br /> ❑NUMBER CVO -231-0t500-1 _ C O. frontage drawn to scale. <br /> TOWNSHIP: SECTION: <br /> Burke 3 '/a: N '/<'/a: S ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 5423 Reiner Rd, Sun Prairie, WI <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> Monument Sign with EMC ❑ Zoning District <br /> . 5I This project is a new building or structure. ❑ Permitted Use? <br /> ❑This project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural Address <br /> EWER 1EPTIC (new/existing) <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) <br /> 7.0 ❑ Wetland/F000dplain/ <br /> AREA TO NEAREST SQUARE FOOT: — Shoreland (attachment) <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) <br /> BASEMENT: 1ST FLOOR: ❑ <br /> ErosionControl permit <br /> 4, TOTAL SQUARE FOOTAGE: , (slopes,disturbance, <br /> 2ND FLOOR: 3RD FLOOR: filling/access) <br /> 32.9 <br /> LI Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: and available options. <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ ♦ ♦ $ 1 3,800.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? Des ❑No r4Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes ❑No 12 Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? lilies ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? Des ENO <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) [Yes EVo ODon't know <br /> 7. Is this to correct a violation? ❑Yes ENO <br /> , <br /> ��� e�A'fl APPLICATION MUST BE SIGNED <br /> ./� 4-CV 1S\D) . (Continue on Back) —0 —0 —0 <br /> 545-112(4/08) 'S��b V CA. <br /> SV CON w\W..iZ4L e6,.3S.), :(MS) <br /> 1 N Go-"\P1,11 cti. i.l'1`IA 1 0,$3 <br />