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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1of2 DCPZP-2014-00522 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE JAY KELLER Capitol Investments (608)444-4791 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 1837 OAKEN VALE RD 13845 West Bullard Road (City,State,Zip) (City,State,Zip) MARSHALL, WI 53559 Evansville, WI 53536 E-MAIL ADDRESS E-MAIL ADDRESS midthun @hotmail.com PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 0811-123-4089-0 TOWN OF SUN PRAIRIE 12 SW SW PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address Is 1837 OAKEN VALE RD subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 9 SAVANNAH VALLEY ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: CENSUS CODE R-1 Residence Description:10'x 5'x 6.66'subd sign 329-Other District Category ❑ Residential El Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. ❑ Other: Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION 8449 ❑ YES ❑ NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ® YES ❑ NO ❑ YES ® NO ❑ YES ® NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 6.66 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $5,197.00 1 Sq.Ft. Sq.Ft. PERMIT FEE $100.00 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner 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 zonin. ordinances. Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent • : Ordinances.Any unauthorized change from the informa•• • •plans submitted will invalidate the permit. _ ' � ..�1� •-44 OFFICE USE ONLY (form version 03.00.07) SURVEY REQU RED'S , DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS / , 08/01/2014 RLB Ail •'ES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: