Laserfiche WebLink
DANE COUNTY ZONING PERMIT Page 1 oft <br /> DCPZP 2015-00022 <br /> OWNER INFORMATION AGENT,CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME <br /> JOHN KLUG (715)938-0249 City&Country Construction LLC (608E <br /> (608)843-6277 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> N12641 WARREN RD & IN ` r 127 North Prairie Street <br /> (City,State,Zip) (City,State,Zip) <br /> WAUSAUKEE,WI 54177 '� Stoughton, WI 53589 <br /> E-MAIL ADDRESS f <br /> E-MAIL ADDRESS <br /> � <br /> .3 v citycountryconstructionllc @yahoo.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 <br /> 1/4 1/4 <br /> 0510-154-8650-0 TOWN OF RUTLAND 15 SE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME <br /> ST.TYPE <br /> (Assignment of new address is 901 GALLAGHER <br /> subject to field verification.) LN <br /> LOT (BLOCK I C.S.M.NO.or PLAT NAME <br /> 1 CSM 10456 <br /> ZONING DISTRICT PARCEL ACj2EAGE PROPOSED PROJECT: Alteration to existing buildin <br /> RH-2 Rural Homes [_(// Description:(3)5'x 4'x 1'egress windows to sfr g CENSUS CODE <br /> District 434- Residential Addition <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ other. Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 8366 <br /> j ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE / WETLAND EC/SW NO. <br /> ® YES El NO ❑ YES H NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 1 Sq.Ft.60 Sq.Ft. 60 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $10 000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $54.50 <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 SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will Invalidate the permit. / 2-0/S- <br /> OFFICE USE ONLY (form version 03 00 07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 01/20/2015 RLB <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials:)(A I 1 f`� P '1) <br />