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DANE COUNTY ZONING PERMIT DCPZP-2017-00355 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DALE P SAUNDERS (608) 219-4603 ULTIMATE CONSTRUCTION INC. (608) 825-4633 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> P.O. BOX 474 4827 PIERCEVILLE ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 COTTAGE GROVE, WI 53527 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> LINNASAUNDERS @GMAIL.COM OFFICE @ULTIMATE-CONSTRUCTION.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0611-161-8145-0 TOWN OF PLEASANT SPRINGS 16 NE NE <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2605 SOUTH HILL ST <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 14521 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT' New Structure/Addition CENSUS CODE <br /> A-2 (2) Agriculture 2 Description:SFR WITH DECK AND PORCH 101 - SFR (detached) <br /> District <br /> Category 0 Residential Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other <br /> Private 13-2017-00170 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 11084 <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 4970 <br /> 20 Sq.Ft 1806 Sq.Ft.3164 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $340,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $422.75 <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 S = • • • : 0 - •gent DATE' <br /> Ordinances.Any unauthorized change from the information or �, <br /> plans submitted will invalidate the permit. -�_ (0 /&. <br /> ! , <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS ' INSPECTION DATE INITIALS <br /> 06/16/2017 PMK2 <br /> 'o; S ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials <br />