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DANE COUNTY ZONING PERMIT ❑CPZP-2016-00236 Page 1of2 <br /> OWNER INFORMATION i AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> LAURENCE G MCGUIRE (608)225-3361 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3454 OLD STONE RD <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON,WI 53589 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> betsykrebsmcguire@gmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0510-231-9930-0 TOWN OF RUTLAND 23 NE SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is • 3454 OLD STONE RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 3 CSM 11820 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> RH-2 Rural Homes .-7-6-7-' Desc ription:8 06-porch replacement over existing foundation 434-Residential Addition <br /> District 7.6287 301 <br /> Category 0 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 9434 <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO Q YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 240 <br /> 12' Sq.Ft. Sq.Ft.240 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $16,900.00 <br /> Sq.Ft. Sq.Ft. PERMIT FEE$68.00 <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: Owner/Agent DATE' <br /> Ordinances.Any unauthorized change from the information or �(�{ ` ♦ 57/0//(e/ <br /> plans submitted will Invalidate the permit. C <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSP r /!r <br /> TIO DAT INITIALS h. . <br /> 05/09/2016 SCW1 � <br /> ❑ YES t NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: —"— y�'' / . ^ IC, P r t K 7 -1 ^ 1 b it(Ke. <br />