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DANE COUNTY ZONING PERMIT Page 1 of 2 <br /> DCPZP 2016-00790 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JONATHAN NEESE (608)279-3400 MODS INTERNATIONAL (314) 406-4350 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4013 COSGROVE DR 5523 INTEGRITY WAY <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53719 APPLETON, WI 54913 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> NEESE @MAC.COM DVOCK @MODSINTERNATIONAL.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0512-141-8060-7 TOWN OF ALBION <br /> 14 NE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 303 CRAIG RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 01735 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1A Residence 1.5 Description:SFR 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: <br /> Private 13-2016-0387 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 6070 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ® YES ❑ NO ❑ YES 0 NO ❑ YES ® NO SE2016-0458 <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 2820 <br /> 29 Sq.Ft.640 Sq.Ft. 1280 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $247,949.00 <br /> 2 Sq.Ft.770 Sq.Ft. 130 PERMIT FEE <br /> $261.50 <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 ordinance . <br /> Owner&Agent hereby agree to comply with all Dane County SIGNA ' RE Own /A ent DATE: <br /> Ordinances.Any unauthorized change from the information or "t.�, 1 /1 /6 <br /> plans submitted will invalidate the permit. 4' ` <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVE 'EQUIR D? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 12/19/2016 HJH3 <br /> YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initial;/' 4 " 1 <br />