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DANE COUNTY ZONING PERMIT DCPZP2015-00316 Page 1 of 2 <br /> OWNER INFORMATION i AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DISTRICT COUNCIL OF MADISON INC SOCIETY OF ST VINCENT (608)278-2920 BRIAN STODDARD (608) 588-3691 <br /> DE PAU <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1109 JONATHON DR 2033 FISH HATCHERY 550 SUNRISE DR#201 <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53713 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> bstod @avearch.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0709-352-2710-0 TOWN OF MADISON 35 NW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2033 FISH HATCHERY RD <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 1 CSM 12040 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> C-2 Commercial Description:two canopys 324 -Offices <br /> District <br /> Category ❑ Residential ® Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B-County Highway 531 <br /> YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES ® NO ❑ YES ® NO 0 YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 434 <br /> 12 Sq.Ft. Sq.Ft.434 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $37,500.00 <br /> Sq.Ft. Sq.Ft. <br /> PERMIT FEE <br /> $275.00 <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 Dane County zoning inspectors for the <br /> purposes of determining compliance with the zoning or `nanc-: <br /> Owner&Agent hereby agree to comply with all Dane County SIGNAT "E: 0 . -r/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. �� 5 -w -'5 <br /> OFFICE USC ONLY (form version 03.00.07) <br /> SURVEY R UIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 05/20/2015 SSA1 <br /> ❑ YES ® NO DATE REVIEWED r INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: (� 513]7 J 6 <br />