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DANECOUNTY ZONING PERMIT ZONING PERMIT N0. Page 1 of 2 <br /> DCPZP-2015-00027 <br /> OWNER INFORMATION AGENTiCONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> VERIDIAN HOMES AB LLC (608)226-3100 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 6801 SOUTH TOWNE DR <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON,WI 53713 <br /> E-MAIL ADDRESS E-MAIL ADDRESS - <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0910-203-1643-0 TOWN OF WINDSOR 20 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4395 DUTCH DIAMOND WAY <br /> (subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 263 HOLLAND FIELDS-FIRST ADDITION <br /> ZONING DISTRICT CEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-3 Residence .23 Description:SFR WITH FRONT PORCH 101 -SFR(detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other. <br /> Public 5388 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-AU Other 8893 <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES la NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 3649 <br /> 22 Sq.Ft.1573 Sq.Ft.2076 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $200,724.00 <br /> 1 Sq.Ft. Sq.Ft PERMIT FEE <br /> $323.68 <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 SIGNATU rrE: • ner/Agent ATE: <br /> Ordinances.Any unauthorized change from the Information or t 3-/c <br /> plans submitted will Invalidate the permit. `• tl r <br /> OFFICE USE ONLY (form version 03.00.071 <br /> SURVEY REQUIRED 2 DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 01/23/2015 PMK2 <br /> YES ❑ NO DATE REVIEWED INITIALS t,Q 2nd INSPECTION DATE INITIALS <br /> j�l. <br /> Initials: a 1. Sg 1 <br />