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DANE COUNTY ZONING PERMIT DCPZP 2 0 5 0 0106 0 Page 1of2 <br /> OWNER INFORMATION 1 AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> THOMAS MUELLER (608) 935-2751 FLEMING DEVELOPMENT (608) 277-8887 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> PO BOX 145 2960 TRIVERTON PIKE, SUITE 202 <br /> (City,State,Zip) (City,State,Zip) <br /> DODGEVILLE, WI 53533 MADISON, WI 53711 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> MUELLNY1 @FRONTIER.COM KWIERWILL @FLEMINGDEVELOPMENT.COM <br /> PARCEL NO. TOWNSHIP SECTION 1.4 1/4 1/4 <br /> 0510-072-8010-0 TOWN OF RUTLAND <br /> 7 NW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4633 STATE HIGHWAY 138 <br /> subject to field verification.) <br /> (LOT (BLOCK C.S.M NO.or PLAT NAME 93 r .. 'i <br /> 1 I ctrl -,-" <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT New Structure/Additio i14rs CENSUS CODE <br /> C-2 Commercial 3.5 Description 40'X 30'SALT SHED 329- Other <br /> District ,-, 0 nr) <br /> _ p , <br /> Category ❑ Residential ® Commercial ❑ Agricultural SEWER A` SANITARY PERMIT NO. <br /> ❑ Other Public �����Opti'�N? <br /> ROAD CLASSIFICATION REZONE NO C U.P NO VARIANCE NO ^0 7t"'". DEED tRESTRICTION <br /> A-US or State Highway 10674 Cki <br /> 0 YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES ❑ NO ❑ YES 0 NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 1200 <br /> 15 Sq.Ft Sq Ft. 1200 - <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $3,000.00 <br /> 1 Sq Ft Sq.Ft PERMIT FEE <br /> $400.00 <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 SIGNATURE: Owner/Agent DAT : <br /> Ordinances.Any unauthorized change from the information or / <br /> plans submitted will invalidate the permit. ' _`4 ' //' /5 <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/09/2015 PMK2 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials ] <br /> I <br />