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DANE COUNTY ZONING PERMIT DCPZP2015-00366 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> RYAN STODOLA (608)658-4853 CLASSIC CUSTOM HOMES (608) 850-4450 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 727 WEALD BRIDGE RD 401 N. CENTURY AVENUE <br /> (City,State,Zip) (City,State,Zip) <br /> COTTAGE GROVE, WI 53527 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> RYAN.STODOLA @MGSCHOOLS.NET NICOLE @CCHOFWAUNAKEE.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0711-271-9445-0 TOWN OF COTTAGE GROVE 27 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2204 NORA RD <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 1 CSM 13204 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RH-1 Rural Homes 2 Description:SFR WITH DECK AND PORCH. 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: <br /> Private 13-2015-00157 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 10324 ❑ YES 0 NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> O YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 6520 <br /> 27 Sq.Ft.2570 Sq.Ft.3950 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $387,851.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $539.00 <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 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: !w;erlA•� '. DATE: l (21/C <br /> Ordinances.Any unauthorized change from the information or 1/ ' I lft <br /> plans submitted will invalidate the permit / / <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/02/2015 PMK2 <br /> ❑\� g ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials /Jfl� <br />