~r LAND USE APPLICATIONH~. Madison Plan Commission215 Martin Luther King Jr. Blvd; Room LL-100POBox 2985; Madison, Wisconsin 53701-2985Phone: 608.266.4635 I Facsimile: 608.267.8739

• The following information is required for all applications for PlanCommission review except subdivisions or land divisions, whichshould be filed with the Subdivision Application.

• Before filing your application, please review the informationregarding the LOBBYING ORDINANCE on the first page.

• Pleaseread all pagesof the application completely and fill in allrequired fields ..

• This application form may also be completed online atwww.cityofmadison ..com/planning/plan.html

• All Land Use Applications should be filed directly with theZoning Administrator.

1.. Project Address: /3:21Skhilt ~-f.Project Title (if any): VA-/ - t( - S-...h~C;:-2. This is an application for:

FOR OFFICE USE ONLY:

Amt. Paid Receipt No.

Date Received

Received By

ParcelNo.

Aldermanic District

GQ

Zoning District

For Complete Submittal

Application Letter of Intent---

IOUP LegalDescript.Plan Sets

Alder Notification

Zoning Text

Waiver

Ngbrhd..AssnNot..---Date Sign Issued

Waiver

Project Area in Acres: /---''----

Zoning Map Amendment (check the appropriate box(es) in only one of the columns below)

~ Rezoning to a Non-PUD or PCD Zoning Dist.: Rezoning to or Amendment of a PUD or PCD District:Existing Zoning: L3 to 0 Ex. Zoning: to PUD/PCD-GDPProposedZoning(ex: Rl, R2T, C3): /}jl 0 Ex. Zoning: to PUD/PCD-SIP

0 Amended Gen. Dev. Plan 0 Amended Spec. Imp. Plan0 Conditional Use 1l25I Demolition Permit 0 Other Requests'(Speci/y):

PropertyOwner(if not applicant):. _

StreetAddress: - ..

4. Project Information:

Zip:

Provide a brief description of the project and all proposed usesof the site:

af),%S;rMUfl- Ad r #1I!eE #CJ«S'CS. I r ,......,--rt r1 .I /. s t...Development Schedule: Commencement 'JUIIII 1\' )OJ2-Completion ~t;zJ T /' /012.....

I CONTINUE~

http://www.cityofmadison

5. Required Submittals:o Site Plans submitted as follows below and depicts all lot lines; existing, altered, demolished or proposed buildings;

parking areas and driveways; sidewalks; location of any new signs; existing and proposed utility locations; buildingelevations and floor plans; landscaping, and a development schedule describing pertinent project details:• Seven (7) copies of a full-sized plan set drawn to a scale of one inch equals 20 feet (collated and folded)• Seven (7) copies of the plan set reduced to fit onto 11 inch by 17 inch paper (collated, stapled and folded)• One (1) copy of the plan set reduced to fit onto S V2inch by 11 inch paper

o Letter of Intent: Twelve (12) copies describing this application in detail including, but not limited to: existingconditions and uses of the property; development schedule for the project; names of persons involved (contractor,architect, landscaper, business manager, etc.); types of businesses; number of employees; hours of operation;square footage or acreage of the site; number of dwelling units; sale or rental price range for dwelling units; grosssquare footage of building(s); number of parking stalls, etc.

o Legal Description of Property: Lot(s) of record or metes and bounds description prepared by a land surveyor. Forany application for rezoning, the description must be submitted asan electronic word document via CDor e-mail. Forapplications ~ng rezoning to more than one district, a separate description of each district shall be submitted.

,1151 Filing Fee: See the fee schedule on the application cover page..Make checks payable to: City Treasurer..

o Electronic Submittal: All applicants are required to submit copies of all items submitted in hard copy with theirapplication (including this application form, the letter or intent, complete plan sets and elevations, etc.) as AdobeAcrobat PDFfiles on a non-returnable CD to be included with their application materials, or in an e-mail sent topcaoplications@citvofmadison ..com. The e-mail shall include the name of the project and applicant. Applicantsunableto provide the materials electronically should contact the Planning Division at (60S) 266-4635 for assistance..

In Addition, The Following Items May Also Be Required With Your Application:

O' For any applications proposing demolition or removal of existing buildings, the following items are required:Prior to the filing of an application, the applicant or his/her agent is required to notify a list of interestedpersons registered with the City 30 or 60 days prior to filing their application using the online notificationtool found at: https:llwww.cityofmadison.com/developmentCenter/demolitionNotificationl

• A photo array (6-12 photos) of the interior and exterior of the building(s) to be demolished or removed..Awritten assessment of the condition of the building(s)to be demolished or removed is highly recommended..Note: A Reuseand Recycling Plan approved by the City's Recycling Coordinator is required prior to issuanceof wrecking permits and the start of construction ..

o A Zoning Text must accompany all PlannedCommunity or Planned Unit Development (PCD/PUD)submittals.6. Applicant Declarations:o Conformance with adopted City plans: A/l1cations shilll ':: in accordancewith all adoptedCity of Madisonplans:

-7 The site is located within the ttmtts of the: 'OrefH5/ 1Jl: Plan, which recommends:~ ~--~

o Pre-application Notification: Section 2S..12 of the Zoning Code requires that the applicant notify the district alderand any nearby neighborhood & business associations in writing no later than 30 days prior to filing this request:

Pre-application Meeting with staff: Prior to preparation of this application, the applicant is required to discusstheproposed development and review process With~O' .0' ".00'0, Dlvision ~ff;. 0'00staff ,,"'0' 'O'ptlPlanningSta~(jht{tJfP~ Date: \ \\ \\ Zoningstaff:/lItt-+I7tii!KE1.!.. Date:It I Jb II

o Check here if this project will be receiving a p blic subsidy. If so, indicate type in your Letter of Int nt.

Signature

Date

tion to Property Owner ..5fJrnG

rm is accurately completed and all required materials are sub

Effective April 27, 2009

http://https:llwww.cityofmadison.com/developmentCenter/demolitionNotificationl

Page 1TitlesDANE COUNTY CERTIFIED SURVEY MAP NOo _ DOCUMENT NO. _ BEING PART OF O.L. 13, BURKE ASSESSORS'S PLAT NO.1; LOCATED IN THE SE 1/4 OF LLC w SURVEYOR • C",..,,..., A .:S" ' 1I\.-_1Ij ! •• i BASIS OF BEARINGS LEGEND LOT 1 '" //l~' I \ ~. II 111/ i: POPE) \ ,I " 0 u' • I ~ /, SOl'28'OS"W I SOl°29'55"WI