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DANE COUNTY ZONING PERMIT Page 1of2 <br /> DCPZP-201600168 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ROBERT H JOHNSON (608) 576-8677 STEVEN JOHNSON (608) 576-7959 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 275 US HIGHWAY 12 & 18 275 US HIGHWAY 12 & 18 413 ALLEN ST <br /> (City,State,Zip) (City,State,Zip) <br /> CAMBRIDGE, WI 53523 CAMBRIDGE, WI 53523 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jacresllc @yahoo.corn sjohnson4506@charter.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0612-024-8285-0 TOWN OF CHRISTIANA <br /> 2 SE NE <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 282 RODNEY <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.(JO.or PLAT NAME <br /> 1 CSM 14005 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSE PROJECT: New Structure/Addition CENSUS CODE <br /> A-2 (8)Agriculture 9.1 Description:lagriculture shed 328- Other Non-Residential <br /> District <br /> Category ❑ Residential ❑ Commercial ® A ricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 10810 ❑ YES 0 NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES ® NO ❑ YES © NO 0 'ES )I NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 7020 <br /> 28 Sq Ft. Sq.Ft.7020 <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $80,500.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $576.50 <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 bepartment 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 SIGNA yRE: Owne Age,it, DATE: <br /> Ordinances.Any unauthorized change from the information or 1 <br /> plans submitted will invalidate the permit. 41',-111 I .- it( e 3 ,0: <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/13/2016 SSA1 <br /> ® YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 1�5 <br /> 1 <br />