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DANE COUNTY ZONING PERMIT DOING PER 5-00O. Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION; . <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME iONE <br /> TED &JILL BIER (608) 843-1295 SUE FROHLING (608) 661-1100 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number.Street) <br /> 5017 PICCADILLY DR 4868 HIGH CROSSING BLVD <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53704 MADISON, WI 53704 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> unirdna @hotmail.com sfrohling @tobhomes.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0910-294-4015-0 TOWN OF WINDSOR <br /> 29 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST TYPE <br /> (Assignment of new address is 6658 DUSKY GLN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 273 CSM 13792 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-2 Residence 0.43 Description:Single Family Home with deck and porch 101 - SFR (detached) <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 /> E-All Other 9229 ❑ YES (J NO <br /> S <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES Vi NO ❑ YES © NO ❑ YES 0 NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SOUAI E FE:. <br /> 4589 <br /> 22 Sq.Ft. 1927 Sq.Ft.2662 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $276,250.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $394.18 <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 ccnstruction <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 ■ww.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 URE: Owner/Agent DAT <br /> Ordinances.Any unauthorized change from the information or if <br /> plans submitted will invalidate the permit. �i �/ <br /> OFFICE USE (fQ 4440'1 <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st,NSPECTION DATE INITIAL S <br /> 04/09/2015 SSA1 <br /> ® YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> l <br /> Initials: `J <br />