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ZONING PERMI <br /> DANE COUNTY ZONING PERMIT DCPZP 2021-00348 Pagel oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> EDUARDO D TATAJE (608) 358-2522 H&H Pools & Spas (608) 963-3099 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3564 Superior Oak Dr., PO Box 486 <br /> (City,State,Zip) (City,State,Zip) <br /> Verona, WI 53593 Montello, WI 53949 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> danieltataje@gmail.com rhardell@wipools.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-293-2166-0 TOWN OF MIDDLETON 29 SW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST TYPE <br /> (Assignment of new address is 3564 SUPERIOR OAK DR <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 16 TUMBLEDOWN FARM <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> SFR-08 Single Description:20x40 inground pool 329 Other <br /> Family Residential <br /> Category ❑ Residential EI Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> ® Other in-ground pool <br /> ROAD CLASSIFICATION REZONE NO. CU.P.NO. VARIANCE NO. DEED RESTRICTION <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ❑ NO ❑ YES ❑ NO 111 YES ❑ NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 800 <br /> Sq.Ft. Sq.Ft.800 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $73,350.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $130.00 <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 SI ,ATU- : Owner/Age•t DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. .f (p O� .,V2 <br /> OFFICE USE ONLY (form version 04.00.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/22/2021 SC W 1 <br /> �// ® YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />