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DANE COUNTY ZONING PERMIT DCPZP-20150005 Page1of2 <br /> 2 <br /> OWNER INFORMATION y:AGgNTICONTRAPTOR! QI M4T x* t <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PiIONE <br /> DAVID C HERZOG (608) 628-5651 MARTEN BUILDING & DESIGN (608) 2.12-3934 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7009 BRIAR LN P.O. BOX 64 <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> DCHERZOG @GMAIL.COM RANDY @MARTENBUILDING.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0911-193-0133-0 TOWN OF BRISTOL 19 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME S1 TY'E <br /> (Assignment of new address is 30 PARKER P,,SS <br /> subject to field verification.) ^ <br /> LOT BLOCK - 70� C.S.M.NO.or PLAT NAME <br /> 13 PARKER'S PLACE <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture .77 Description:SFR WITH PORCHES AND DECK 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO <br /> ❑ Other: <br /> Private 13-2015-00076 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-AII Other , <br /> [ YES H N <br /> , <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES la NO ❑ YES © NO ❑ YES 0 NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEE I <br /> 5777 <br /> 33 sq.Ft. 1313 Sq.Ft.2732 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $423,487.00 <br /> 2 Sq.Ft. 1732 Sq.Ft. PERMIT FEE <br /> $483.28 <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 /> 1 <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 ■ e URE: /w,le A. nt DA1 E: 1 <br /> Ordinances.Any unauthorized change from the information o'111.kh6� <br /> plans submitted will invalidate the permit. _ L411 7 <br /> OFFICE USE ONLY (form yerstpitt Q.34111)4 - <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/07/2015 PMK2 <br /> �-0 YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />