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DANE COUNTY ZONING PERMIT DCPZP 20 5 00173 Page 1 of <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME <br /> COVANCE LABORATORIES INC PHONE <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> ACCOUNTS PAYABLE-02 3301 KINSMAN BLVD <br /> (City,State,Zip) <br /> MADISON, WI 53704 (City,State,Zip) <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0810-294-0101-5 29 <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME <br /> (Assignment of new address is 3301 ST.TYPE <br /> subject to field verification.) Kinsman BLVD <br /> C.S.M.NO.or PLAT NAME <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition <br /> Development District 40.17 Description:temp.crane CENSUS CODE <br /> 329-Other <br /> Category ❑ Residential ® Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. <br /> E-All Other DEED RESTRICTION <br /> ❑ YES IA NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 0 <br /> 160 Sq.Ft. Sq.Ft. <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $0.00 <br /> 0 Sq.Ft. Sq.Ft. <br /> PERMIT FEE <br /> $200.00 <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 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 ors••ances. <br /> Owner&Agent hereby agree to comply with all Dane County SIG . , ; • -r/A. - • DA <br /> Ordinances.Any unauthorized change from the information or ; /' <br /> plans submitted will invalidate the permit. 'Y/i 6-- <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑ YES ® NO 04/14/2015 SSA1 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />