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id <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page l of <br /> DCPZP-2014-00923 I'. <br /> OWNER INFORMATION AGENT CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> WI DNR DANE COUNTY LAND AND WATER (608)224-3730 <br /> RFCIII 117r:FC <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> PO BOX 7921 5201 FEN OAK DR <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON,WI 53701-7921 MADISON,WI 53718 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JAMES @COUNTYOFDANE.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0710-323-8000-9 TOWN OF BLOOMING GROVE 32 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST./TYPE <br /> (Assignment of new address is 4401 LIBBY RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE t <br /> RE-1 Recreational 131 Description:Dane County Parks Storage Building 328-Other Non-Residential <br /> District <br /> Category ❑ Residential 0 Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ® Other.PARK STORAGE BUILDING Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION I. <br /> C-Town Road 10732 ❑ YES 0 NO <br /> , <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES fa NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 26 C Sq.Ft. Sq.FL 11734 ) 1, 13'� <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR #Error <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $0.00 �. <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 subject <br /> 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 difficult <br /> to identify. Failure to comply may result in removal or modification of construction that violates the law or <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> 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 SI I -E: Owner/A e8 / DATE: <br /> Ordinances.Any unauthorized change from the Information or 'll / %; i <br /> plans submitted will Invalidate the permit. / /i /jl d , <br /> OFFICE USE ONLY (form version 03.00 07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ® NO 12/26/2014 HJH3 <br /> YES <br /> DATE REVIEWED INITIALS` 2nd INSPECTION DATE INITIALS <br /> Intia `'D.-V\,\� 1S <br />