Laserfiche WebLink
DANE COUNTY ZONING PERMIT ZONING PERMIT NO Page 1 of 2 <br /> DCPZP-2014-00835 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> HPT TA PROPERTIES TRUST (617)964-8389 (31aue,Pyre,Schomer,Burns a<Dehaven,Inc-Cyamia Naas (216)927-8649 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 255 WASHINGTON STREET SUITE 300 5595 Transportation Blvd, Suite 100 <br /> (City,State,Zip) (City,State,Zip) <br /> NEWTON, MA 02458 Cleveland, OH 44125 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> cnolde @gpdgroup.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0810-081-9920-5 TOWN OF BURKE 8 NE SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 5901 US HIGHWAY 51 <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 <br /> C-2 Commercial 10.73 Description:remodel of travel center 324-Offices <br /> District new entry way(vestiblue) <br /> Category ❑ Residential ® Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> p Other. Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> A-US or State Highway 848 <br /> YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 21.4 sq.Ft. Sq.Ft 12395 16427 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $625,000.00 <br /> 2 Sq.Ft.4023 Sq.Ft. PERMIT FEE <br /> $1450.00 <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 SIGNATURE: Owner/Age r v DATE: 143v by <br /> yOrdinances.Any unauthorized change from the information or i 1 ' <br /> plans submitted will invalidate the permit. 1.611.6140/ •/, . 8. , e _AV. , ,rued <br /> OFFICE USE ONLY (form version 03 00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 10/28/2014 SSA1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />