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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1 of 2 <br /> DCPZP-2015-00132 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MC MAHAN REV TR,PERRY AND PATRICIA (608)832-6204 MCMAHAN DEVELOPMENT (608)235-3503 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1144 PRIMROSE CENTER RD 2958 NORTH ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> MT HOREB,WI 53572 BLUE MOUNDS, WI 53517 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PPMCMAHAN @HOTMAIL.COM MCMAHANDVLPMNT @AOL.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0507-103-9180-7 TOWN OF PRIMROSE <br /> 10 SW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 1144 PRIMROSE CENTER RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 02916 <br /> r <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Ex Exclusive Ag 2.4 Description:SFR 101 -SFR(detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2015-00055 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> ❑ YES ❑ NO <br /> • <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 /> 5916 <br /> 23 Sq.Ft.2437 Sq.Ft.3479 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $350,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $493.70 <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 SIGNA E: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. I <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 03/27/2015 PMK2 <br /> IO YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />