Laserfiche WebLink
DANE COUNTY ZONING PERMIT ZONING PERMIT 1 NO. Pagel oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JOSHUA ROUNDS (608) 669-0186 Gehin Custom Homes (608) 576-9536 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> "22tfOTATE - ? 7 / s w I I G vv t-r,; 1 u i, W3238 Daytonwood Rd. <br /> (City,State,Zip) (City,State,Zip) <br /> OREGON, WI 53575 Belleville, WI 53504 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0509-272-4067-7 TOWN OF OREGON 27 NW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 498 Hillcrest LN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 7 OREGON ASSESSOR'S PLAT,TOWN OF <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1A Residence 1.95 Description:Single family residence,4 bedrooms 101 -SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> 111 Other <br /> Private 12 - 2016-00296 <br /> ROAD CLASSIFICATION REZONE NO. . NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road (\ 1 ❑ <br /> YES ca NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO EC2016-0383 <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 6291 <br /> 30'-6" Sq.Ft. 1536 Sq.Ft.3519 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $500,000.00 <br /> 2 Sq.Ft. 1236 Sq.Ft. PERMIT FEE <br /> $521.83 <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 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: Owne • • - D'TE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. A f - — L (v- L(. <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 10/26/2016 DJ E1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: I 0 .-Ci i r_ Pm t/ <br />