Laserfiche WebLink
DANE COUNTY ZONING PERMIT Page 1 of 2 <br /> DCPZP20 600178 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> TIMOTHY BALLWEG (608) 333-1316 Mounds Creek Siding Inc. (608) 444-4515 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 10199 US HIGHWAY 14 4973 State Rd 78 <br /> (City,State,Zip) (City,State,Zip) <br /> MAZOMANIE, WI 53560 Mazomanie, WI 53560 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> mcsinc5973 @gmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0806-222-8050-8 TOWN OF BLACK EARTH 22 NW NE <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTIOIJ STREET NAME ST.TYPE <br /> (Assignment of new address is 10199 US HIGHWAY 14 <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 09400 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> RH-3 Rural Homes Description:removed detached garage and add attached garage 434- Residential Addition <br /> District <br /> Category 0 Residential ❑ Commercial ❑ Agficultural SEWER SANITARY PERMIT NO <br /> ❑ <br /> Other Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NCO. VARIANCE NO DEED RESTRICTION <br /> A-US or State Highway 7590 <br /> 0 YES p NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 740 <br /> 12 Sq.Ft. Sq.Ft.740 <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $72,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $105.50 <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 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 /> i <br /> Owner&Agent hereby agree to comply with all Dane County SI NAT R • ter/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. Y -Zv'e <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/20/2016 SC W 1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: i <br />