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SUPPLEMENT to Web-App P <br /> ZONING PERMIT APPLICATION www.countyofdane.com <br /> PROPERTY OWNER INFORMATION <br /> CUSTOMER TO PROVIDE <br /> OWNER NUE O'Reilly Auto Parts <br /> [3 Zoning Status;CUP; <br /> OWNERADDRESS(Number.Skeet.CiM Stale.Zip) <br /> Deed Restriction;CSM <br /> 1826 S Stoughton Rd Madison WI <br /> Variance(# ) <br /> NOOK PHONE CELL PHONE E-MAL ADDRESS <br /> (417)520-4556 tsharp13@oretilyauto.com ['Site Plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION and includes dimensions <br /> AGBIT?MAE CONTRACTOR NAIR <br /> Bauer Sim and Lighting Bauer Sign and Lighting El Site Plan incheing location <br /> AGENT ADDRESS COMRACTOR ADORESS of wel/septic <br /> 2500 S 170th Street 2500 S 170th Street <br /> (cay,stme.DP) (CIIM SMIX ZIP) 0 Setbacks <br /> New Berlin WI 53151 New Berlin WI 53151 <br /> PHONE PHONE El Site Plan approval from <br /> (262) 784-0500 (262) 784-0500 appicable township. <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Floor plans to scale <br /> adlugiebauersignusa.com adlugi@bauersignusa.com El <br /> PROPERTY LOCATION INFORMATION (http: accessdane.co.dane.wi.us ) <br /> El Elevation of property <br /> pANENr PARCEL NUMBEFt CURRENIZONINa ACREAGE: <br /> ElPARCEL <br /> 6-1 NUMBER 008/0710-161-9620-3 64 ..s./3 - S frontage drawn to scale. <br /> TOPMNSHIP: SECT1OM <br /> Blooming Grove <br /> 12 Driveway pennits <br /> Town of <br /> 'A: WA: rivewa <br /> (state,county,town) <br /> ADDRESS: <br /> 1826 S Stoughton Rd Madison WI <br /> El Sanitary pemits <br /> GSM LOT SUBONISION BLOCIDLOT <br /> (pubic,private) <br /> PROPOSED PROJECT INFORMATION ''; 040R01J RN- <br /> -'' .,>-.A.--°- <br /> PROJECT DESCRIPTIOM <br /> Replace existing building signs with proposed artwork 0,;.7 %zo,iskpolitict-7 <br /> -....2„, <br /> • [JThis project is a new building or structure. 1]t1.: :1401141?-7, <br /> -;-r.•,.e, - , ... -,- , -v <br /> project is an addition/alteration to an existing building or structure. <br /> alitioilAdd&ds <br /> &WARY SERVICe PERMIT NUMBEIt <br /> '-(1104teAtkid ' <br /> DEWIER n'EPrIC <br /> MIGHT IN FEET: / c NUMBER OF STORE& pia indmilmi basement) a'VVBSVdlHiiDdiW- <br /> ShOfBILVId tatlaCIM18110 <br /> AREA TO NEAREST SQUARE FOOT: <br /> (Oultad* e dimensions inducing unshed area,attached garages and above grade decks or Porches) 0,600oncontrd ronit <br /> EtASBABIT: <br /> 1ST FUX311t < ''') 4 TOW.SQUARE Foomee 4, (itOles:466Ixiiice, <br /> /g7 71 , fiattaicess) <br /> MD FLOOR <br /> 0 Reviewl.:0mcalonsuiver <br /> ESTIMATED CONS1RUC1ION COST <br /> -+ --■ --■ -+ -■ --■ $ and availableoptions. <br /> (Please round to nearest dollar) <br /> 1. The property is withitl 300 feet of a stream or 1000 feet from a pond or lake?........... DYes EINo IN Po I know <br /> 2. Is there a wetland or floodplain on or near the property? Efres B: SiDo 1 Imes/ <br /> 3. Have you talked with the Mwnship about your project and are they in agreement? ElYes <br /> 4. Has there been a zoning permit issued for this property in the past 5 years? [yes D4o <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) Ekes ca a am <br /> I know <br /> 7. Is this to correct a violation? Ores ESI • <br /> tPPUCATION on MUST BE.+SIGNED <br /> 545412 WOO) <br />