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DANECOUNTY ZONING PERMIT ZONING PERMIT NO p;,li.,i,{2 <br /> DCPZP-2015-00219 <br /> OWNER INT ORMATION AGENT:CON TRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JASON KIRCH (608)393-6434 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7225 LINSLEY LN <br /> (City,State,Lp) (City,State,Z.ip) <br /> SAUK CITY,WI 53583 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> the_hulk@hotmail.com <br /> SECTION 1/4 1/41/4 <br /> 0907-183-6121-0 TOWN OF ROXBURY 18 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new aridness Is 7202 Flyhawk LN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 21 BLACKHAWK FIELDS <br /> ZONING DISTRICT P CEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1 Residence .469 Description:sfr 101 -SFR(detached) <br /> District <br /> Category ® Residential 0 Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ r: Private 13201500110 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 9814 <br /> D 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 /> 15 sq.Ft.1623 sq.FL 3091 4714 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $237,000.00 • <br /> 1 Sq.Ft, FL PERMIT FEE <br /> $403.55 <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 /> Ow eandent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: <br /> Arty unauthorized change from the information or <br /> plans submitted will invalidate the permit. / , <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 0 4128/2 01 5 SCW1 <br /> ril;/YES ❑ NO DATE REVI WED, INITIALS \ 2nd INSPECTION DATE INITIALS <br /> 1 <br /> Initials: ` - CC S )I 1 41) <br />