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DANE COUNTY ZONING PERMIT Page 1 of 2 <br /> DCPZP 2015-00161 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> TODD B SCHROEDER (608) 225-2201 MARTEN BUILDING & DESIGN (608) 212-6934 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 860 GARDEN DR UNIT 63 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 /> TODD.SCHROEDER @KRAFTFOODS.COM RANDY @MARTENBUILDING.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0911-191-2265-0 TOWN OF BRISTOL 19 NE NW <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3019 MIDNIGHT SUN DR <br /> subject to field verification.) <br /> LOT 'BLOCK I C.S.M.NO.or PLAT NAME <br /> 45 1 NORWAY ROAD ESTATES <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition <br /> A-1 Agriculture .77 CENSUS CODE <br /> 9 Description:SFR WITH PORCHES 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other Public 13-2015-00080 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO DEED RESTRICTION <br /> E-All Other <br /> ❑ YES D NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO <br /> ❑ YES ® NO ❑ YES ra NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 21 Sq.Ft. 1954 Sq.Ft.3316 5270 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $368,953.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $445.25 <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 /> 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 SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or [� / <br /> plans submitted will invalidate the permit. ! 1 1c�-/S <br /> • <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑ YES ® NO 04/10/2015 PMK2 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 1111. SF <br />