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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page lof2 <br /> DCPZP-2015-00146 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE • : AGENT/CONTRACTOR NAME PHONE <br /> TERRY LEE FRYE (608) : :-8820 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3104 TIMBER LN <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA,WI 53593 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> makfrye @yahoo.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0608-061-9220-5 TOWN OF VERONA <br /> 6 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3104 TIMBER LN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 00581 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1 Residence 2 Description:addition to existing garage 434 - Residential Addition <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANIlAR7 PEI't.t <br /> Private <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICT ION <br /> C-Town Road 2573 0 YES @ 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 /> 1910 <br /> 16 Sq.Ft. Sq.Ft.1910 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $2,900.00 <br /> 1 Sq.Ft. Sq.Ft. ,t <br /> I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the ownjn;.:i 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 SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. /JJ.-Lk-Lk, `'--/-/,/ <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/03/2015 SSA1 <br /> YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> r J <br /> Initials: /11(r Z( ^\p I ---- -- - ----- ----- <br />