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DANECOUNTY ZONING PERMIT ZONING PERMIT NO. Page 1 oft DCPZP-2015-00239 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE TRUCK STOP LLC (608)884-9451 JNB Signs Incorporated (608)754-6338 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 568 HAUGEN RD 1221 Venture Drive (City,State,Zip) (City,State,Zip) EDGERTON,WI 53534 Janesville,WI 53546 E-MAIL ADDRESS E-MAIL ADDRESS I90truckstop @gmail.com PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 0512-271-9570-1 TOWN OF ALBION 27 NE SE PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 568 HAUGEN RD subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME METES AND BOUNDS ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New StructurelAddltlon CENSUS CODE C-2 Commercial Description:10'x 10'x 100'pylon sign,19'x10',25'x4.5', 18'x 3.5' 329-Other District appendage signs Category ❑ Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. ❑ Other: Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION A-US or State Highway 3555 473, 2011 ❑ YES El NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES ® NO ❑ YES ❑ NO ® YES ❑ NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 100 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR #Error 1 Sq.Ft. Sq.Ft. PERMIT FEE $0.00 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure to comply with any provision or condition of this permit renders this zoning permit null and void and subject to enforcement action. I acknowledge that I am responsible for complying with State and Federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources web page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the purposes of determining compliance with the zoning ordinances. Owner&Agent hereby agree to comply with all Dane County SIGNATURE.'wner/Age)it DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit. OFFICE USE ONLY (form version 03.00.07) SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 05/01/2015 RLB YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials:ll t C/