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DANE COUNTY ZONING PERMIT DCPZP-201500432 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> RHONDA J BLAKE (608) 845-9352 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7499 MIDTOWN RD <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> blakeri @tds.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0608-051-8561-0 TOWN OF VERONA 5 NE NW <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7499 MIDTOWN RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> RH-2 Rural Homes 5.8 Description:screened porch addn 434 - Residential Addition <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Other: Private <br /> ROAD CLASSIFICATION REZONE Na C.U.P.NO. VARIANCE NO DEED RESTRICTION <br /> C-Town Road 7296 ❑ YES Q NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES 0 NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 256 <br /> 19 Sq.Ft Sq.Ft.256 <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $17,000.00 <br /> 1 Sq Ft. Sq Ft. PERMIT FEE <br /> $69.20 <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 <br /> subject to enforcement action. <br /> I acknowledge that I am responsible for complying with State and Federal laws concerning construction <br /> near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be <br /> difficult to identify. Failure to comply may result in removal or modification of construction that violates <br /> the law or other penalties or costs. For more information, visit the Department of Natural Resources web <br /> page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. <br /> I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the <br /> purposes of determining compliance with the zoning ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County SIG ATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or /^ ///, / <br /> plans submitted will invalidate the permit. 1 // :.L'( W 1 O L• Ma II <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INS 'CTION DATE INITIALS <br /> 06/16/2015 SC W 1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd <br /> M 2nd INSPECTION DATE INITIALS <br /> Initials:/ O ' ' .-. 1 ll '•, K <br />