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SUPPLEMENT to Web-App # <br /> ZONING PERMT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE an OWNER NAME <br /> Novation Senior Apartments, LLC CEI <br /> P; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) Deed lietCYCSM <br /> 4015 80th St,Kenosha,WI 53142 <br /> Vari nce(# ( (0(5 ) <br /> HOME PHONE CELL PHONE E-MAIL ADDRESS 0L � <br /> (262)842-0452 (312)405-3277 adam @beardevelopment.com le pwlydrawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and in des dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Eric Mitchell Construction Management Ass am`Y7Y ite Plan including to ti� , <br /> AGENT ADDRESS CONTRACTOR ADDRESS � e tic <br /> 4015 80th St;Suite F 4015 80th St;Suite F ((�� <br /> (City,State,Zip) (City,State,Zip) 0 Setbacks L5 ecoc-L l <br /> Kenosha,WI 53142 Kenosha,WI 53142 <br /> PHONE PHONE <br /> Q Site Plan approval from <br /> (312) 613-6180 (312) 613-6180 applicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> eric.mitchell @cmaofwi.com eric.mitchell @cmaofwi.com 0 Floor plans to scale <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) levation of property <br /> PARENT PARCEL NUMBER: CURRENT ZONING: ACREAGE: P P rty <br /> El PARCEL 032070936323450 <br /> �,/ pop 1.57 frontage drawn to scale. <br /> NUMBER <br /> TOWNSHIP: SECTION. <br /> Town of Madison 3 69 1/4: 5 Ui .1/4t/4: Sui 51 Driveway permits <br /> ADDRESS: (stat ,county,town) <br /> 2675 Novation Parkway <br /> CSM: LOT SUBDIVISION BLOCK/LOT S-••.. permits <br /> 13,543 1 (p •tic, •rivate) <br /> PROPOSED PROJECT INFORMATION " " <br /> PROJECT DESCRIPTION: ol, <br /> Novation Senior Commons t ' f. ,� <br /> r4 This project is a new building or structure. , f ,p,,,-`M' <br /> ❑This project is an addition/alteration to an existing building or structure." A <br /> SANITARY SERVICE: PERMIT NUMBER: <br /> r3 <br /> EWER F— 17,011,011 ` ` -� � ti <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) ,. <br /> �4 8 , <br /> 5' ' 4.0 � - � "� -; a 44AF e <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Outside dimensions including unfinished area,attached garages and above grade decks or porches) ' . <br /> BASEMENT: 1 5,684.0 1ST FLOOR: 15,420.0 j TOTAL SQUARE FOOTAGE: 4, : II4 <br /> 4 <br /> 2ND FLOOR: 15,530.0 3RD FLOOR: 15,530.0 77,501.0 <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ ♦ ♦ g1f tIOA,S_ <br /> (Please round to nearest dollar) $ 6,554,006.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑Yes EiNo ❑Don't know <br /> 2. Is there a wetland or floodplain on or near the property? ❑Yes No ❑Don't know <br /> 3. Have you talked with the township about your project and are they in agreement? QYes ❑No <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑Yes IN No <br /> 5. Is this project associated with a rezone/CUP/variance(petition/appeal# ) -ave blank if none) <br /> 6. Is a location survey required? (see reverse) r-s Jlo 51Don't know <br /> 7. Is this to correct a violation? a es ✓ Jo <br /> APPLICATION MUST BE SIGNED <br /> 545-112(4/08) (Continue on Back) <br />