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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1of2 <br /> DCPZP-2015-00063 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> BRAD R GAUSMANN (608)764-1495 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1908 STRAWBERRY RD <br /> (City,State,Zip) (City,State,Zip) <br /> DEERFIELD, WI 53531 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> bg1950t @hotmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0711-111-9400-0 TOWN OF COTTAGE GROVE 11 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 1908 STRAWBERRY RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 l CSM 13484 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-2 Agriculture 19.96 Description:104'x 50'x 22'ag stor shed 329-Other <br /> District <br /> Category ❑ Residential ❑ Commercial ® Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 10120 ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ❑ NO ® YES ❑ NO ® YES ❑ NO EC-2015-0028 <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 5200 <br /> 22 Sq.Ft. Sq.Ft.5200 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $27,500.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $440.00 <br /> I, the undersigned, and 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 SIGN weer/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or / <br /> plans submitted will invalidate the permit. )G—! <br /> e <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑ YES RI NO <br /> 02/18/2015 RLB <br /> (V}- DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials�� <br />