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DANE COUNTY ZONING PERMIT DCPZP-2015-00124 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> TYLER J SANBORN (608)770-0280 Ambiance Homes Inc. (608)225-4594 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1113 W MAIN ST 5838 Grassland Terrace <br /> (City,State,Zip) (City,State.Zip) i <br /> SUN PRAIRIE, WI 53590 Marshall, WI 53559 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tksanbom @gmail.com ambiancehomesinc @charter.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0811-123-4199-0 TOWN OF SUN PRAIRIE 12 SW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 1808 Yelk RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 19 SAVANNAH VALLEY <br /> ZONING DISTRICT ARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1 Residence .78 Description:sfrw/porch&deck 101 -SFR(detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private 13201500057 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 8249 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES 0 NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT let FLOOR TOTAL SQUARE FEET <br /> 23 Sq.Ft.2038 Sq.FL 3841 <br /> 5879 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $250,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $490.93 <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 :a. A RE: Own - .t DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will Invalidate the permit �_ 1/v `'- - L. • -_ _ .ZW AS <br /> OFFICE IJSG (Mil V (fnnn vorsinn 0100 07) <br /> SURVEY REQUIRED 7 DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 03/25/2015 SCW 1 <br /> 0 YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: At/ <br />