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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Pagelof2 DCPZP-2016-00391 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE ROBERT F CORLISS (608)225-9585 Matthew Kent (608)482-0580 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 1251 COUNTY HIGHWAY D 5667 Concord Drive (City,State,Zip) (City,State,Zip) OREGON,WI 53575 Fitchburg,WI 53575 E-MAIL ADDRESS E-MAIL ADDRESS hope4ur @hotmail.com mattkent23 @hotmail.com PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 0509-082-9740-1 TOWN OF OREGON 8 NW SE PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 1251 COUNTY HIGHWAY D subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 3 CSM 06698 ZONING DISTRICT PARCEL ACREAG PROPOSED PROJECT: Alteration to existing building CENSUS CODE A-1 Ex Exclusive Ag Description:14'x 9'x 2'open deck addition to residence 434- Residential Addition District Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. ❑ Other: Private 13-1996-0101 ROAD CLASSIFICATION REZONE NO. , C.U.P.NO. VARIANCE NO. DEED RESTRICTION DCPREZ-0000-00800 ❑ YES 0 NO SHORELAND FLOOD ZONE / WETLAND EC/SW NO. ❑ YES ® NO ❑ YES W NO ❑ YES NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 130 2 Sq.Ft. Sq.Ft.130 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $8,000.00 1 Sq.Ft. Sq.Ft. PERMIT FEE $59.75 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure to comply with any provision or condition of this permit renders this zoning permit null and void and subject to enforcement action. I acknowledge that I am responsible for complying with State and Federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources web page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the purposes of determining compliance with the zoning ordinances. Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Owner/A ent DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit. N/4, 6/L OFFICE USE ONLY (form version 03.01.00) t SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 06/27/2016 RLB ❑ NO DATE REVIEWED / INITIALS 2nd INSPECTION DATE INITIALS Initials. [\ / '6) / ? i�Mi/