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SUPPLEMENT to Web-App # <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME ST JOSEPH'S VENTURES LLC <br /> ❑Zoning Status;CUP; <br /> OWNER ADDRESS (Number,Street,City,State,Zip) <br /> Deed Restriction; CSM <br /> 1902 W BELTLINE HWY Madison,WI 53713 Variance(# ) <br /> HOME PHONE CELL PHONE E-MAILADDRESS <br /> (608)222-1243 TravisG @gansercompany.com <br /> ❑Site Plan drawn to scale <br /> AGENT INFORMATION I CONTRACTOR INFORMATION and includes dimensions <br /> AGENT NAME CONTRACTOR NAME <br /> Ganser Company/Travis Ganser Grant Signs(DP Industries LLC) ❑Site Plan including location <br /> AGENT ADDRESS CONTRACTOR ADDRESS of well/septic <br /> 1906 W Beltline 2810 Syene Rd. <br /> (City,State,Zip) (City,State,Zip) ❑Setbacks <br /> Madison,WI 53713 Madison,WI 53713 <br /> PHONE PHONE <br /> El Site Plan approval from <br /> (608) 222-1243 (608) 838-7794 applicable township. <br /> E-MAILADDRESS E-MAILADDRESS <br /> TravisG @gansercompany.com Dan @GrantSigns.net ❑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 /> IN PARCEL 032/0709-344-8720-6 C-1 2.42 frontage drawn to scale. <br /> NUMBER _ <br /> TOWNSHIP: SECTION: <br /> Madison 34 1/4: NW %/4%/4. SE ❑Driveway permits <br /> ADDRESS: (state,county,town) <br /> 1902 W Beltline HWY <br /> CSM: LOT SUBDIVISION BLOCK/LOT ❑Sanitary permits <br /> (public,private) <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: ,,( <br /> Remove 3 existing pole signs; Install 1 new pylon as shown on attached design drawing. 1 Zoning District <br /> . 4 This project is a new building or structure. 4 Permitted Use? <br /> OThis project is an addition/alteration to an existing building or structure. <br /> SANITARY SERVICE: PERMIT NUMBER: ❑ Rural/Address`,`A <br /> EWER PEPTIC (new/existing) 1—/�(► <br /> HEIGHT IN FEET: NUMBER OF STORIES: (Not including basement) 1 <br /> 41.5 LI Wetland/Floodplain/ <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: 4, (slopes,disturbance,Nix <br /> 2ND FLOOR: 3RD FLOOR: filling/access) It?r,ey 300.0CI ReviewLocation <br /> ESTIMATED CONSTRUCTION COST: ♦ ♦ ♦ ♦ and available options. <br /> ♦ ♦ <br /> (Please round to nearest dollar) $ 138,000.00 <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? [Yes ✓❑No ODon't know <br /> 2. Is there a wetland or floodplain on or near the property? [Yes '4No ODon't know <br /> 3. Have you talked with the township about your project and are they in agreement? Dies ONo <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? ❑1(es ONo <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) DYes ENo ODon't know <br /> 7. Is this to correct a violation? [Yes ✓❑No <br /> APPLICATION MUST BE SIGNED <br /> 545112(4/08) (Continue on Back) <br />