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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1 of 2 <br /> DCPZP-2015-00150 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DAVID W (ANNE (608)849-6770 Premier Builders (608) 849-6770 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) T <br /> 3038 BUNKER VW 102 N Holiday Drive <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 Waunakee, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> iannedave @yahoo.com jeanette.acker @tds.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0911-303-0524-0 TOWN OF BRISTOL 30 SW E <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME T.TYPE <br /> (Assignment of new address is 3097 FrarTs GRN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 64 BRISTOL GARDENS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CTNSUS GOUT <br /> A-1 Agriculture .763 Description:sfr wI porch&deck 101 - SFR (dl trtche(1) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ <br /> Other: Private 13201500074 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other <br /> 0 YES I2) 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 FEE I <br /> 6953 <br /> 19 Sq.Ft.2585 sq.Ft 4368 _ <br /> PROJEC :3:',' <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $41() ODD CO <br /> 1 Sq.Ft. Sq.Ft. PERMI f-i Eili. — 1 <br /> $$571.48 <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 to ci ffic it <br /> to identify. Failure to comply may result in removal or modification of construction that •/Iolate_. t,e 1c ✓ C <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page :Jt <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 SIGNATURE: weer/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or ----. / <br /> plans submitted will invalidate the permit. , / <br /> OFFICE USE ONLY (form verglon 03.0.0.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DA1E INI I Uv_S <br /> 04/06/2015 SCW1 <br /> ® YES ❑ NO DATE REVIEWED INI VIALS i:nd INSPEC I ION DA I E INf I IA. <br /> Initials: "- <br />