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DANE COUNTY ZONING PERMIT DCPZ PERMIT 0 Page 1of2 <br /> ZONING 2015-0 1 O <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> VERIDIAN HOMES AB LLC (608)226-3100 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 6801 SOUTH TOWNE DR <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON,WI 53713 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0910-203-1654-0 TOWN OF WINDSOR 20 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of newaddressls 4391 DUTCH DIAMOND WAY <br /> subject to field verification.) <br /> LOT (BLOCK C.S.M.NO.or PLAT NAME <br /> 264 HOLLAND FIELDS-FIRST ADDITION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-3 Residence .2 Description:SFR W/DECK y,,rovvf pock 101 -SFR(detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Public 5387 <br /> ❑ Other. <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 8893 ❑ YES la NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> O YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 3578 <br /> 23.5 Sq.Ft 964 Sq.Ft.1716 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $233,183.00 <br /> 2 Sq.Ft.898 Sq.Ft PERMIT FEE <br /> $318.35 <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 ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County = ;, ', :I s I' <br /> plans submitted Any unauthorized change r from the Information or � <br /> plans submitted will invalidate the permit. i� <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 03/30/2015 HJH3 <br /> •, YES ❑ NO DATE REVI D INITIALS 2nd INSPECTION DATE INITIALS <br /> a-�IS ,SS <br />