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DANE COUNTY ZONING PERMIT DCPZP-2015 00281 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> KENNETH G HOVIND (608) 575-4510 HART DENOBLE BUILDERS INC (608) 831-4422 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4511 SHOOTING STAR AVE 7923 AIRPORT ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> MIDDLETON, WI 53562 MIDDLETON, WI 53562 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> HART @DENOBLEBUILDERS.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-082-8450-0 TOWN OF MIDDLETON 8 NW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7557 SUMMIT RIDGE TRAIL <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 2 CSM 12728 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture 1.5 Description:5 BDRM SFR+front and rear porch 101 -SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2015-00121 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-AII Other <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES VI NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 8129 <br /> 25 Sq.Ft.3033 Sq.Ft.5096 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $575,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $1319.36 <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 'ATE: <br /> Ordinances.Any unauthorized change from the information o ( _ <br /> plans submitted will invalidate the permit. AT L/V 0�✓/y /r ()IAA 'I,Zao <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 05/12/2015 SJ W 3 <br /> YES ❑ NO DATE REVIEW INITIALS YYY__ 2nd INSPECTION DATE INITIALS <br /> Initials: S / I I5 <br /> ( <br />