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DANE COUNTY SHORELAND ZONING PERMIT ZONING PERMIT NO Page 1 of 2 <br /> DCPSH L-2015-00012 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> BRIAN R MARQUARDT (608)837-4755 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1610 ESKER TRL <br /> (City,State,Zip) (City.State,Zip) <br /> COLUMBUS,WI 53925 <br /> E-MAIL ADDRESS EMAIL ADDRESS <br /> BRIANMARQUARDT24@GMAIL.COM <br /> PARCEL NO TOWNSHIP SECTION 114 1/4 114 <br /> 0911-121-0120-0 TOWN OF BRISTOL 12 NE NE <br /> _ J <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION 'Si itttTNAME ST.TYPE <br /> (Assignment of new address Is 1610 ESKER TRL <br /> subject to Reid verlfloetlon.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 50 DRUMLIN CREEK <br /> ZONING DISTRICT PARCEL SO FOOTAGE PROPOSED PROJECT: New Structure AddItlon <br /> A-1 Agriculture 17975 DeseriptIon:SHED 18 X 24 <br /> District <br /> PROJECT INFORMATION App for a Residential Structure: SEWER <br /> Septic <br /> REZONE NO. C.UP.NO. VARIANCE NO. DEED RESTRICTION <br /> D YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND <br /> ® YES U NO 2 YES ® NO 12 YES ® NO <br /> Existing Impervious Proposed Impervious <br /> Sq.Ft 0 sq.Ft 324 <br /> • <br /> Setback from Ordinary High Water Mark Water Body Name <br /> 280 UNNAMED PERMIT FEE <br /> $150.00 <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 8 Agent hereby agree to comply with all Dane County SIG. TURE• s, er/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. S t <br /> OFFICE USE ONLY florin version 01 01 OOl <br /> DATE ISSUED INITIALS INSPECTION DATE INITIALS <br /> 03/10/2015 HJH3 <br /> DATE REVIEWED INITIALS <br />