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DANE COUNTY ZONING PERMIT Pagel oft <br /> DCPZP-2013-00927 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> LEE E KING (608) 963-8050 PO BOX 412 (608) 767-2729 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 9852 COUNTY HIGHWAY Y 1527 U.S. Highway 14 <br /> (City,State,Zip) (City,State,Zip) - <br /> MAZOMANIE, WI 53560 Black Earth, WI 53515 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dave @meigsbuilds.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0906-231-9280-5 TOWN OF MAZOMANIE 23 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 9852 COUNTY HIGHWAY Y <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 1 CSM 03893 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition <br /> CENSUS CODE <br /> RH-1 Rural Homes 3.8 <br /> Description:54 x 38 shed 329-Other <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. <br /> B-County Highway 2529 DEED RESTRICTION <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES 0 NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 24 Sq.Ft. Sq.Ft.2052 2052 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $32,000.00 <br /> 1 Sq.Ft. Sq.Ft. <br /> PERMIT FEE <br /> $203.90 <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 premiss- by Dane County zoning inspectors for the <br /> purposes of determining compliance with the zonine ord nan es. <br /> Owner&Agent hereby agree to comply with all Dane County SIG U : Ow n / ATE' <br /> Ordinances.Any unauthorized change from the information or'\ 4 <br /> plans submitted will invalidate the permit. t2-(26 <br /> OFFICE USE ONLY (form version 03 00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑ YES ® NO 12/20/2013 SJW3 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />