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DANE COUNTY ZONING PERMIT �T N.ocPZP 207 O Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JAMES S LUGGE (847)561-3113 RECREATIONAL CONCEPTS INC (608)835-2780 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2097 RIVER ESTATES LN 121 N MAIN ST <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON,WI 53589 OREGON, WI 53575 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> RECCONINC@YMAIL.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4114 <br /> 0611-291-8460-2 TOWN OF PLEASANT SPRINGS 29 NE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2097 RIVER ESTATES LN <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 /> R-1 Residence 2.31 Description:20 X 40 INGROUND POOL 329-Other <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricuitural SEWER SANITARY PERMIT NO. <br /> ❑ Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 1390 <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ® YES ❑ NO ❑ YES ® NO o YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 0 Sq.Ft 800 Sq.Ft 800 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $50,000:00 <br /> 0 Sq.Ft Sq.Ft PERMIT FEE <br /> $220.00 <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 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 SIGNATURE:Owner/A ent DATE: <br /> Ordinances.Any unauthorized change from the Information or ‘ ` , <br /> plans submitted will invalidate the permit_ <br /> 46 s , . Ati _l _ i !i <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INtTiALS 1st INSPECTION DAB INITIALS <br /> ❑ YES ® NO 09/11/2017 HJH3 <br /> DATE REVIEWED _ INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />