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ZONING PERMIT APPLICATION www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME POINT STORAGE- STEVE JUIRIS <br /> ❑Zoning Status; CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed Restriction; CSM <br /> 3700 COMMERCE DRIVE, MADISON WI 53719 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS <br /> (847)254-6340 sjuiris @gmail.com <br /> 12 Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> JENNIFER MUELLER APPLETON SIGN COMPANY ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 2400 HOLLY RD 2400 HOLLY RD <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> NEENAH, WI 54956 NEENAH, WI 54956 <br /> PHONE PHONE ❑Site Plan approval from <br /> (920) 560-6822 (920) 378-3490 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JENM @APPLETONSIGN.COM JOSHT @APPLETONSIGN.COM ❑Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) ❑ Elevation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> 0 PARCEL 070826286502 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION: <br /> MIDDLETON 1/4: 1/41/4: ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 3700 COMMERCE DRIVE, MADISON WI 53719 <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public, private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: <br /> INSTALL ONE(1) SET OF LED FACE-LIT CHANNEL LETTERS W/BOX LOGO(SEE DRAWINGS) CI Zoning District <br /> . O 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 FIEPTIC (new/existing) <br /> HEIGHT IN FEET NUMBER OF STORIES: (Not including basement) <br /> 1.0 ❑ Wetland/Floodplain/ <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 1ST FLOOR: <br /> ❑ ErosionControl permit <br /> TOTAL SQUARE FOOTAGE: j, (slopes,disturbance, <br /> filling/access) <br /> 2ND FLOOR: 3RD FLOOR: <br /> 43.0 <br /> Cl Review Location Survey <br /> ESTIMATED CONSTRUCTION COST: -+ ♦ ♦ -► -► ♦ and available options. <br /> (Please round to nearest dollar) $ 6,741.45 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes 'lo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yeslo ['Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? ❑✓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/appeal# ) (leave blank if none) <br /> 6. Is a location survey required? (see reverse) Elves ❑No C2Don't know <br /> 7. Is this to correct a violation? Elves ✓❑No <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) -+ -* <br />