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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1 of 2 <br /> DCPZP-2015-00044 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> STATE AT MAIN DEVELOPMENT LLC (6,e8)=2, 14- Ambiance Homes Incorporated (608)225-4594 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 200 N MAIN ST 5838 Grassland Terrace <br /> (City,State,Zip) (City,State,Zip) <br /> OREGON, WI 53575 Marshall, WI 53559 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ambiancehomesinc©charter.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0910-293-6397-0 TOWN OF WINDSOR 29 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4380 SCENIC VIEW RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 37 PRAIRIE CREEK SUBDIVISION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-4 Residence �1 Description:sfr w/cov frt por,open deck,coy deck 101 -SFR (detached) <br /> District V_ 5 <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Public —1 0t l,c <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other <br /> ��1 1 ❑ 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 /> 4824 <br /> 23 sq.Ft.1844 Sq.Ft.2980 <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $212,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $411.80 <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 perform rt of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply with th es. I understand that failure <br /> to comply with any provision or condition of this !rmit null and void and subject <br /> to enforcement action. /� � �, S <br /> I acknowledge that I am responsible for complyi V C;�-��I vs concerning construction <br /> near or on wetlands, lakes, and streams. Wetla (' e ith open water can be difficult <br /> to identify. Failure to comply may result in rem 2 fiction that violates the law or <br /> other penalties or costs. For more information, 31 Resources web page at <br /> www.dnr.state.wi.us or contact the Department ul INdtulal i.cok..u.....,,, 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 "II •T RE: Own r • • DATE: <br /> Ordinances.Any unauthorized change from the information Qr n 1 i LS <br /> plans submitted will invalidate the permit. L <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITI \ 1st INSPECTION DATE INITIALS <br /> 02/04/2015 RLB <br /> YES El NO DATE REVIEWE INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 5--\Lk'K <br />