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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. '''.7-':!t , . -,, DCPZP-2014-00902 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE EDWIN M BORKE (608) 764-2063 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 3714 DEERFIELD RD (City,State,Zip) (City,State,Zip) DEERFIELD, WI 53531 E-MAIL ADDRESS E-MAIL ADDRESS edborke @gmail.com PARCEL NO. TOWNSHIP SECTION 1/4 .4 0712-193-9200-0 TOWN OF DEERFIELD 19 SW SVb' PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST TYPE (Assignment of new address is 3714 DEERFIELD RD subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 2 CSM 10730 ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building A-2 (2)Agriculture 4.2 g 9 CENSUS CODE ( ) g Description:bedroom and screen porch addition 434- Residential Addition District Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NC ❑ Other: Private 13-2014-0004 08 ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. C-Town Road 8633 DEED RESr1�iclotl ❑ YES y, NC SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 16 Sq.Ft.968 Sq.Ft. 1168 2136 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $258,000.00 1 Sq.Ft. Sq.Ft. PERMIT FEE 8210.20 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the c ner of the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure to comply with any provision or condition of this permit renders this zoning permit null and void and subject to enforcement action. I acknowledge that I am responsible for complying with State and Federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources web page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the purposes of determining compliance with the zoning ordinances. Owner&Agent hereby agree to comply with all Dane County SIGNATU Owner/Agent zr DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit. ,/ /L/2- " (� OFFICE USE ONLY (form version 03.00.07) SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 1=I YES ® NO 12/02/2014 SSA1 DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: