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DANE COUNTY ZONING PERMIT DCPZP-2015 00296 Page 1 of <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DEBORAH SPENCER ANDERSON - :: 332-6606 <br /> BILLING ADDRESS(Number,Street) •VS) ADDRESS(Number,Street) <br /> 1675 WASHINGTON ST <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI ,,, twtealliPINt:le <br /> E-MAIL ADDRESS lt� - "v•unc- •a AM4gNx f:R �MAIL Ay <br /> DD <br /> RESS <br /> andergrO dson-k12.wi.us iNr• W . <br /> PARCEL NO. -Ol '"" ,. SECTION 1/4 1/4 1/4 <br /> 0607-343-6148-1 TOWN OF SPRINGDALE 34 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 1675 WASHINGTON ST <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 8 2 MOUNT VERNON WITH BYAM'S ADDITION(SPRINGDALE) <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> R-2 Residence 0.3 Description:replace nonconforming 23x5.5 front porch 434- Residential Addition <br /> District <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 /> A-US or State Highway <br /> ❑ 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 /> 12 Sq.Ft. Sq.Ft.126.5 <br /> 253 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $25,000.00 <br /> 2 Sq.Ft. 126.5 Sq.Ft. PERMIT FEE <br /> $68.98 <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 SI .TORE: Owner/ ge t DATE: <br /> Ordinances.Any unauthorized change from the information or t44,,plans submitted will invalidate the permit. , c,7„.., ><n - 1.5--1 <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 05/15/2015 SJ W 3 <br /> ES NO DATE REVIEWED 1116 INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 3c3 G _. f <br />