Laserfiche WebLink
DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1of2 <br /> DCPZP-2016-00327 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> AMIE L PITTMAN (608)835-8807 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 5093 LINCOLN RD <br /> (City,State,Zip) (City,State,Zip) <br /> OREGON,WI 53575 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> gregg @customd.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0509-141-8520-7 TOWN OF OREGON <br /> 14 NE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 5093 LINCOLN RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.cr PLAT NAME <br /> 1 CSM 03106 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> LC-1 Limited 5.0 Description:new roof over existing deck 434-Residential Addition <br /> Commercial Dist <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 8518 <br /> ❑ YES ® 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 /> 635 <br /> 8 Sq.Ft. Sq.Ft.635 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $4,200.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $97.63 <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 construction <br /> near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult <br /> to identify. Failure to comply may result in removal or modification of construction that violates the law or <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 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 SIGNATURE: Owp DATE: <br /> Ordinances.Any unauthorized change from the Information or ,^ (� <br /> plans submitted will invalidate the permit. t/Y W r 1- 16 <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/07/2016 SSA1 <br /> ❑ YES ® NO DATE REVIEW INITIALS • r 2nd INSPECTION DATE INITIALS <br /> Initials: ( r I4 F/.p../( <br />