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DANE COUNTY ZONING PERMIT Page 1of2 DCPZP-2015-00013 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE MICHAEL J LINN (646) 831-8597 MARIA KOVACH (608) 513-0309 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 1629 KINGSMILL WAY#104 PO BOX 92 (City,State,Zip) (City,State,Zip) MADISON, WI 53718 SUN PRAIRIE, WI 53590 E-MAIL ADDRESS E-MAIL ADDRESS MICHAELJLINN @OUTLOOK.COM MARIA @SIMPLYSTATEDINTERIORS.COM PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0710-051-3035-7 TOWN OF BLOOMING GROVE 5 NE NW PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 325 POWERS AVE subject to field verification.) LOT BLOCK I C.S.M.NO.or PLAT NAME 1 9 GALLAGHER, ELISHA L REPLAT OF BLOCK 9 OF 2ND ADDITION ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE R-3 Residence 0.217 Description:roof replacement 101 -SFR (detached) District Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. ❑ Other: Public ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION D-Unadopted Subdiv Streets 768 YES ® NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES 0 NO ❑ YES ® NO ❑ YES ® NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 1025 12.5 Sq.Ft. Sq.Ft. 1025 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $43,356.00 1 Sq.Ft. Sq.Ft. PERMIT FEE $50.00 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 zoning ordinances. Owner&Agent hereby agree to comply with all Dane County SIGNATURE: OwneldAgent DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit. OFFICE USE ONLY (form version 03.00.07) SURVEY REQUIRED 7 DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 01/15/2015 SJ W 3 ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: