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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1of2 <br /> DCPZP-2021-00353 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DAVID DORST (608) 515-3089 DELTA REMODELING (608) 535-7109 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4324 DAMASCUS TRL 2995 GANNON ST <br /> (City,State,Zip) (City,State,Zip) <br /> COTTAGE GROVE, WI 53527 MADISON, WI 53711 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> D2DRUMS@GMAIL.COM JOSUE@DELTAREMODELINGWI.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0711-083-0294-0 TOWN OF COTTAGE GROVE <br /> 8 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4324 DAMASCUS TRL <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 14 MEADOW GROVE <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> RR-8 Rural 0.65 Description:REAR DECK ADDN 434- Residential Addition <br /> Residential District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-ATI Other <br /> YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ® NO ❑ YES ® NO ❑ YES I NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 404 <br /> 1.5 Sq.Ft. Sq.Ft.404 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $36,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $90.40 <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/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or . e <br /> plans submitted will invalidate the permit. Z 4t 6/23/2021 <br /> OFFICE USE ONLY (form version 04.00.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/23/2021 SLJ3 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />