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ZONING PERMIT APPLICATION FOR A SIGN www.countyofdane.com SUPPLEMENT to Web-App # <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NAME C <br /> J L1)'(4Z ❑Zoning status; CUP; Deed <br /> OWNER ADDRESS (Numb Street,City,State,Zip) <br /> �JO o RoJ ` Ie-1 i v1 t Restriction;Variance <br /> HOME PHONE CELL PHONE E-MAIL ADD ESS <br /> `J 7- ,i '5 SSk+ 6,„It5 ec harug%rt-+ [ i]Site plan drawn to scale <br /> AGENT INFORMATION CONTRACTOR INFORMATION including dimensions <br /> ANT NAME � � CONTRACTOR NAME <br /> GAro Mall ',-4d'9/S ,,,A,.c JOE RGO ❑Setbacks <br /> AGENT ADDRESS CONTRACTOR ADDRESS <br /> (7oS' W&, sJ Q Detailed drawings to scale <br /> (City,State,Zip) (City,State,Zip) <br /> ibb�x tA.,T I q Q Elevation plan drawn to <br /> PHONE PHONE scale <br /> yon- 9 to <br /> E-MAILADDRESS E-MAIL ADDRESS ❑Illumination plans(if <br /> JOE@ARTISANDECKANDDESIGN.COIVI applicable) <br /> PROPERTY/LOCATION INFORMATION (http://accessdane.co.dane.wi.us/) 111 Wisconsin DOT approval <br /> PARCEL NUMBER: CURRENT ZONING: ACREAGE: <br /> 43%-i zc3 FF52o_7 HG 1.21 (if applicable) <br /> TOWNSHIP' 11��)ft <br /> SECTION: <br /> Vie 2r f <br /> ADDRESS: <br /> 67b r L)./Ys 12..e.-4 ii10414LAA ,w� ✓"�7I <br /> CSM: LOT SUBDIVISION BLOCK/LOT <br /> PROPOSED PROJECT INFORMATION STAFF REVIEW <br /> PROJECT DESCRIPTION: ARTISAN <br /> � �� S `� DECK AND ❑ Zoning district <br /> . ❑This project is a new sign. DESIGN ❑ Permitted use <br /> 'This project is an addition/alteration to an existing sign. <br /> DISTANCE TO LOT LINE(FEET: ❑ Square footage <br /> requirements <br /> SIGN HEIGHT(FEET): 1L4 ❑ Height requirements <br /> SIGN COPY AREA(SQUARE FEET): Av ❑ Locational requirements <br /> SPEED LIMIT(MPH): ❑ Review location survey <br /> and available options <br /> TYPE OF SIGN: (WALL/GROUND/PYLON): (,,j 1 <br /> ESTIMATED CONSTRUCTION COST: rn� <br /> (Please round to nearest dollar) ♦ ♦ ♦ ♦ --► I $ '�W <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? nYes WNo DDon't know <br /> 2. Is there a wetland or floodplain on or near the property? nYes 1No ❑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? nYes ❑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) nYes No ['Don't know <br /> 7. Is this to correct a violation? , JYes ❑No <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -► -► -0- <br /> 545-112(4108) <br />