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DANE COUNTY ZONING PERMIT ZONING 2015- NO. Page 1 oft , <br /> 2015 00165 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME <br /> JOHN D SHERRICK (641)430-3871 PHONE <br /> BILLING ADDRESS(Number,Street) <br /> ADDRESS(Number,street) <br /> 2392 COUNTY HIGHWAY AB <br /> (City,State,Zip) <br /> MCFARLAND, WI 53558 (City,State,Zip) <br /> E-MAIL ADDRESS <br /> SHERRICK@NETCONX.NET E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 <br /> 0610-144-5321-6 1/4 1/4 <br /> TOWN OF DUNN 14 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME <br /> (Assignment of new address is 2392 COUNTY HIGHWAY AB ST.TYPE <br /> subject to field verification.) <br /> LOT 'BLOCK I C.S.M.NO.or PLAT NAME <br /> 11 2 ORVOLD'S PARK- <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing buildin <br /> R-3 Residence .27 Description:REPLACE PATIO WITH DECK X 36 g CENSUS CODE <br /> District 329-Other <br /> Category ® Residential 0 Commercial ❑ Agricultural SEWER <br /> SANITARY PERMIT NO <br /> ❑ Other: Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. <br /> B-County Highway VARIANCE NO. DEED RESTRICTION <br /> ❑ YES ® NO <br /> SHORELAND <br /> FLOOD ZONE WETLAND EC/SW NO <br /> ® YES ❑ NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR <br /> TOTAL SQUARE FEET <br /> 1 <br /> Sq.Ft. Sq.Ft.288 288 <br /> PROJECT COST <br /> NO.OF STORIES <br /> 2nd FLOOR 3rd FLOOR <br /> $8,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $71.60 <br /> [, 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 SIG► n <br /> Ordinances.Any unauthorized change from the information or Wner/ t DATE: <br /> plans submitted will invalidate the permit. <br /> OFFICE 115E ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE <br /> HJH3 INITIALS <br /> 0 4,i/ ® NO DATE REVIEWED 015 INITIALS 2nd INSPECTION DATE INITIALS <br /> ,Initials: Al <br />