Town of Buchanan GENERAL BUILDING & ZONING ~ N178 County Road N PERMIT APPLICATION uchana"ib~ Appleton, WI 54915 13 aac;;:&;;:wm Phone: (920) 734-8599 APPLICATION#: J,OJO-tJlg Applicant/Contractor lnfonnatlon Applicant Name (lndlv., Org. or Entity) Authorized Representative TiUe Modem Sheet Metal Megan Krieser Bookkeeper Malling Address City State IPostal Code 2180American Dr Neenah WI 54915 E-mail Address Telephone (include area code) Fax (Include area code)
[email protected] 920-733-4713 920-733-0882 Landowner lnfonnatlon (If different than Applicant) Name (Organization or EnUty) Contact Person TiUe Bob Granger owner Mailing Address City State IPostal Code N280 Rogers Ln Appleton WI 54915 E-mail Address Telephone Onelude area code) Fax (Include area code) 920-788-1614 Project or Site Location Site Address I Location: Parcel ID(s): IPlat I CSM I Lot No.: N280 Rogers Ln tJ300Fh300 Current Zoning: I Current Use: Lot Dimensions: Front: Side: Rear. Side: I LotArea: 0 acres or D square feet Project lnfonnatlon Structure: ~ Trades: §enia~ - f!lacigal a1dg.; §el!li!.!l!s!i -Accessoa a1i;tg.: Iii Principal 0New D Plumbing Front: Side: Front: Side: 0Accessory 0Addition D Electrical Rear. Side: Rear: Side: 0 Other. liJ Other. liJ HVAC bQl CoJ1:er1ge; Laad Disturbance; fmleg !&§gtoUsm; Existing: Area (Sq Ft): Replacement of 1 furnace Proposed: Fill/Ex (Cu Yds): Any IBJICI disturlling aclivltles over 4.000 squa1& Estimated Cost of Project: feat or /UJillfl & excavation IDIBllllfl over 100 cubic Height (to peak): yards 1&qu/18S a saparate erosj)n control & $3,649.00 stonnwater mamigement pennlt. Project Plans (see reverse side) 0 SitePlan 0 Building Plans D Grading/Drainage & Erosion Control Plan/Permit Additional Requirements (Check all that apply) 0 Special Exception No.