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t <br /> DANE COUNTY ZONING PERMIT DCPZP 20 5-001044 Pagelof2 <br /> OWNER INFORMATION AGENT/CONTRACTOR 14F01001.0.004. <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DANE COUNTY MCKEE ASSOCIATES (608) 271-4900 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 210 MARTIN LUTHER KING JR BLVD RM 114 925 WATSON AVE <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53703-3342 MADISON, WI 53713 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> VINCEL @MCKEEASSOCINC.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0807-324-9000-1 TOWN OF BERRY 32 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME S TY ,t <br /> - <br /> (Assignmentofnewaddressis 4894 SCHERBEL RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> 14.5 Description:replace 2-22.3x33 park shelters 329- Other <br /> Category ❑ Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO <br /> ® Other:DANE COUNTY PARKS SHELTER Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> [-C YES Li] NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES 0 NO ❑ YES © NO ❑ YES © NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 1474 <br /> 15 Aciel\i/ Sq.Ft. Sq.Ft. 1474 _ <br /> PR• COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR #Error <br /> Sq.Ft. Sq.Ft. PERMI <br /> $0.00 <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 <br /> subject 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 <br /> difficult to identify. Failure to comply may result in removal or modification of construction that violates <br /> the law or other penalties or costs. For more information, visit the Department of Natural Resources web <br /> page at 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 ,SIG ATURE: Owner/A DA1 E: / _ <br /> Ordinances.Any unauthorized change from the information or� �V (2( �S <br /> plans submitted will invalidate the permit. <br /> .. 1110P° ii <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/02/2015 S J W 3 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 1 2nd INSPECTION DATE INITIALS <br /> Oti Initials: _ 4-0 ( t <br />