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DANE COUNTY ZONING PERMIT DCPZP-2015 00314 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ALAN D STRAUSS (608) 255-9675 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 10486 W BLUE MOUNDS RD <br /> (City,State,Zip) (City,State,Zip) <br /> BLUE MOUNDS, WI 53517 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> AL @WORKTRUCKSTUFF.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0606-212-9502-0 TOWN OF BLUE MOUNDS 21 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 10486 W BLUE MOUNDS RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Ex Exclusive Ag 37 Description:REPLACE EXISTING AGRICULTURAL BARN 328-Other Non-Residential <br /> District (LIVESTOCK) <br /> Category ❑ Residential ❑ Commercial ® Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> D YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ❑ NO ❑ YES ® NO ❑ YES I NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR 6L',(04 . <br /> TOTAL SQUARE FEET <br /> .--5e-r3-S 5 GA) <br /> 21 Sq.Ft. Sq.Ft.-5562 ' <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $50,000.00 <br /> PERMIT FE c,7- v 0 <br /> 1 Sq.Ft. Sq.Ft. (`/ <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 SIG;TUREA O ;er/A•,- t DATE: <br /> Ordinances.Any unauthorized change from the information or , ►� t <br /> plans submitted will invalidate the permit. . ,1 IJ I,#ice 1 • ` ma <br /> OFFICE USE ONLY (form version(.3.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 05/20/2015 HJH3 <br /> YES ® NO <br /> DATE REVIEWED INITIALS +/ 2nd INSPECTION DATE INITIALS <br /> Initial ,5"a ^/ p ii y� <br />