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DANE COUNTY ZONING PERMIT ZONING ERMITNNO. Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ALAN R PEDDER (608) 347-9684 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3629 SABERTOOTH TRL <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53719 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> apedder @charter.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-203-0396-0 TOWN OF MIDDLETON 20 SW NE <br /> PROPERTY ADDRESS HOUSE NO, ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3807 SILVERBELL RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 116 SPRUCE HOLLOW <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture 0.768 Description: 101 -SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private 13-2014-00357 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES WI NO ❑ YES ® NO ❑ YES 0 NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 30 Sq.Ft.2150 Sq.Ft.3408 <br /> 6433 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $430,000.00 <br /> 2 Sq.Ft.875 Sq.Ft. PERMIT FEE <br /> $532.47 <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 SIGNATURE: Owner/A• - t DATE: <br /> Ordinances.Any unauthorized change from the information or dip <br /> plans submitted will invalidate the permit. . � G //—7/ q OFFICE USE ONLY �L ` (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECT O r INIT II.11/07/2014 SSA1 { <br /> ® YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTleN I ATE f �' INITIALS <br /> Initials: /� <br /> it k*IVI tiliti C6kr 4/414 Q16.1460( 5 .4,(eS JITIRM\i'Vp "lee 4(5'104 <br />