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DANE COUNTY ZONING PERMIT ZONING PERMIT NO.2016--00534 Page1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> BRIAN S HEIMSOTH (608) 877-0931 JOHN SCHWINGLE (608) 798-1700 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7894 WOOD POND TRAIL <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 CROSS PLAINS, WI 53528 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> staci.heimsoth @charter.net schwinglebuilders @yahoo.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0706-313-9820-6 TOWN OF VERMONT 31 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3268 RYAN RD <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 2 CSM 03566 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-2 Agriculture 10.58 Description:single family home 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Other: <br /> Private 13-2016-00217 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 2504 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES 0 NO 0 YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 6390 <br /> 24 Sq.Ft.2400 Sq.Ft.3702 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $521,000.00 <br /> 2 Sq.Ft.288 Sq.Ft. PERMIT FEE <br /> $529.25 <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 ■ww.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 SIG •TURE: • . ner/• • -nt DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. ,� ; - /(0 <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/18/2016 SSA1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS \ 2nd INSPECTION DATE INITIALS <br /> Initials: 0118 ( <br />