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DANE COUNTY ZONING PERMITPZPFzo„- Of <br /> OVVNER INFORMAT ON AGENT CONTRACTOR !NFORMAT'ON <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> V&B WENDT PROPERTIES LLC (608)513-7146 <br /> BILLING ADDRESS(Niniber,Street) ADDRESS(Number,Street) <br /> 5559 COUNTY HIGHWAY F <br /> (City,Stale,Bp) (City,State,Zip) <br /> MAZOMANIE,WI 53560 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tn,•Av@tds.net <br /> SECTION 1/4 1/41/4 <br /> 0806-231-8040-9 TOWN OF BLACK EARTH 23 NE NE <br /> PROPERTY ADDRESS HOUSE NO_ ST.DIRECTION STREET NAME ST_TYPE <br /> (Assignment of new address M 5559 COUNTY HIGHWAY F <br /> subject to hell weilication.) <br /> LOT (BLOCK I C.S.M.NO.or RAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> A-1 Ex Exdusive Ag 140.00 Description:attached garage 438-Garage <br /> District <br /> dory ® Residential ❑ Commercial ❑ Agjp ral SEWER SANITARY PERMIT NO. <br /> ❑ Other Private na <br /> ROAD CLASSIFICATION REZONE NO_ C.U.P.NO VARIANCE NO. DEED RESTRICTION <br /> B-County HAY ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO <br /> ❑ YES (a NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 12 Sq.Ft Sq.Ft 720 720 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $37,000.00 <br /> 1 Sq.Ft Sq.Ft PERMIT FEE <br /> $104.00 <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 conceming 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 SIGNATURE:Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit <br /> 7 �7 <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> [] YES ® NO DATE REVIEWED SCW1 <br /> IEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />