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DANE COUNTY ZONING D E RM IT ZONING PERMIT NO. Page 1 of 2 <br /> DCPZP-2016-00464 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE I AGENT/CONTRACTOR NAME PHONE <br /> STUART HODGSON (608) 924.3594 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7693 LONE PINE RD 4 <br /> (City,State,Zip) (City,State,Zip) <br /> BARNEVELD, WI 53507 <br /> E-MAIL ADDRESS I E-MAIL ADDRESS <br /> hbr9 @frontier.Com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0606-081-8651-0 TOWN OF BLUE MOUNDS 8 NE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 10642 County Highway ID <br /> subject to field verification.) <br /> LOT BLOCK C.S.M. VO.or PLAT NAME <br /> 2 CSM 11154 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSEIQ PROJECT': New Structure/Addition CENSUS CODE <br /> RH-4 Rural Homes 16.956 Description:Isfr w/covered porches and deck 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ AgIricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private 13201600148 ` <br /> i <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B-County Highway 8980 ❑ YES ® NO • <br /> I 41 <br /> SHORELAND FLOOD ZONE WETLAI'D EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ l'ES [(NO <br /> I <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 6300 <br /> 12 Sq.Ft.23918 Sq.Ft.3902 PROJECT COST <br /> NO.OF STORIES 2nd FLOOR I 3rd FLOOR $357,000.00 <br /> .1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $522.50 <br /> I, the undersigned, am the owner of the pro erty or an authorized agent acting on behalf of the owner of <br /> the property. I certify that the work to be pe ormed, as part of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply wi h the applicable zoning ordinances. I understand that failure <br /> to comply with any provision or condition of his permit renders this zoning permit null and void and <br /> subject to enforcement action. <br /> I acknowledge that I am responsible for corn lying with State and Federal laws concerning construction <br /> near or on wetlands, lakes, and streams. W tlands that are not associated with open water can be <br /> difficult to identify. Failure to comply may re ult 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 epartment of Natural Resources Service Center. <br /> I hereby consent to the entry on the permitted pre ' .es by Dane County zoning inspectors for the <br /> purposes of determining compliance with the zonin• •rdinances. <br /> Owner&Agent hereby agree to comply with all Dane County N• 'U/- /OwnerlAgent DATE:- <br /> Ordinances.Any unauthorized change from the information or , ' .-4 - 2-6e/W/ <br /> plans submitted will invalidate the permit. ii r4Ati <br /> OFFICE USZ ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 07/26/2016 SC W 1 <br /> v ES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 71 a 1 J C, riK <br />