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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Pagelof2 <br /> DCPZP-2015-00145 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION ,,; .?, ; <br /> OWNER NAME PHONE AGENT/CONTRACT OR NAME PI iONE i <br /> JOSEPH M ROBERTSON (608) 695-9919 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) �__ <br /> 2916 WAUBESA AVE I <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53711 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0610-053-7220-4 TOWN OF DUNN 5 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.-TYPE <br /> (Assignment of new address is 2916 WAUBESA AVE <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 20 3 WAUBESA BEACH-2ND ADDITION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> R-3 Residence .2 Description:RES DECK ADDN 434 - Residential Addition <br /> District <br /> Category ® Residential ❑ Commercial D Agricultural SEWER SANITARY PERMIT NO. <br /> D Other: Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ® YES ❑ NO ❑ YES ® NO ❑ YES ® NO SE2015 00077 <br /> -- <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR —1-'D',-AL :,..C,l.'ARkS �T E' <br /> 18 <br /> 3 Sq.Ft. Sq.FI.48 —i <br /> PROJECI COS i <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $400 00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $107.20 <br /> I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of <br /> the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure <br /> to comply with any provision or condition of this permit renders this zoning permit null and void and subject <br /> to enforcement action. <br /> I acknowledge that I am responsible for complying with State and Federal laws concerning ccnstruc ion <br /> near or on wetlands, lakes, and streams. Wetlands that are not associated with open wai.er can he O i,'fio-a,t <br /> to identify. Failure to comply may result in removal or modification of construction that violates the ltI \ c r <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. <br /> I hereby consent to the entry on the permitted premis:' .y Dane ' oh my zoning inspectors for the <br /> purposes of determining compliance with the zonin: ordina e-.. <br /> Owner&Agent hereby agree to comply with all Dane County 5 ATU RE: i w• IVY: • t DATE: <br /> Ordinances.Any unauthorized change from the information or ' <br /> plans submitted will invalidate the permit. Rra 1 <br /> ONI.V <br /> OFFICE USE + dd ,4)41;:i4,-j.. <br /> "t pp.t y ,-'4 , i4 ' ': ' <br /> SURVEY" 'DUI' I? DATE ISSUED NI TIALS 1 s!h15: ::I ION DO I:," L5 <br /> ill o. NO 04/02/2015 JIIJ <br /> DATE REVIEWED NI IJALS 2nd INSPEr:I SON DA1 F INS I.!_: ' <br /> rHtldl6: 7 I , <br /> 0 AL <br /> . <br />