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DANE COUNTY ZONING PERMIT DCPZP 20 4-00904 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> TIM OBRIEN HOMES (608) 661-1100 MARILYN REARDON <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4868 HIGH CROSSING BLVD <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53704 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> MREARDON @TOBHOMES.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0910-294-2290-0 TOWN OF WINDSOR 29 SE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 6673 DUSKY GLN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 80 WOLF HOLLOW <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODL <br /> R-2 Residence 0.28 Description:SFR,FRONT PORCH,DECK 101 - SFR (du ached) <br /> District <br /> Category lI Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO <br /> Public <br /> Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 9229 YES NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> O YES ® NO 0 YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 3693 <br /> 29 Sq.Ft.901 Sq.Ft. 1767 <br /> PRC.ii CO:; <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR 5262,000 <br /> 2 Sq.Ft. 1025 Sq. Ft. PERMIT FEE <br /> 8326.97 <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 he <br /> difficult to identify. Failure to comply may result in removal or modification of construction that vlol otes <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 SIGN T RE: Owner/Agt DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. j/ /' 2 -3 <br /> OFFICE USE ONLY (form version 03.00.Q7) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1s!INSPECTION DATE IN;TIALS <br /> 12/03/2014 SJ W 3 <br /> YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE l <br /> Initials: ��� <br />