Laserfiche WebLink
DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1of2 <br /> DCPZP-2016-00695 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JEREMIAH J GIESE (608)308-3949 T S Gerrtaretiogg LLC C�r1.�ro,C1.; (608)308-3949 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) r�J <br /> 6126 SUN VALLEY PKWY 809-Kr-eidet Drive j,< r � 01 <br /> (City,State,Zip) (City,State,Zip) Q <br /> OREGON,WI 53575 STOUGHTON, WI•53598— S J' <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tiiii-ereliwefewitip@gmail.com i'i to S cL 1„,e CS n S k t? <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0509-064-8001-9 TOWN OF OREGON 6 SE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 6126 SUN VALLEY PKWY <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-2 Agriculture Description:24'x 24'x 16'det res gar 438-Garage <br /> District ) <br /> Category II 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 dcprez-0000-10095 <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE / WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES El NO ❑ YES El/ NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 576 <br /> 16 Sq.Ft. Sq.Ft.576 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $20,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $93.20 <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 SIGMA URE n- - :r•t DATE: <br /> Ordinances.Any unauthorized change from the information or, /� / / <br /> plans submitted will invalidate the permit. �' 0 6 <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 10/20/2016 RLB <br /> El YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initia J 0 "a ' -/ G) V <br />