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DANE COUNTY ZONING PERMIT DCPZP 2015 00472 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MARK D HALVERSON (920) 988-5248 CLEARY BUILDING CORP (608) 770-0325 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4195 COUNTY HIGHWAY 0 2201 GAINSBORO AVE <br /> (City,State,Zip) (City,State,Zip) <br /> WATERLOO, WI 53594 DAVIS, IL 61019 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> DZEAL @CLEARYBUILDING.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0712-131-8210-0 TOWN OF DEERFIELD 13 NE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4195 COUNTY HIGHWAY 0 <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 12046 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-2 (8)Agriculture 8.17 Description:24X40 GOAT BARN 329-Other <br /> District <br /> Category ® Residential 0 Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> Other: Private <br /> 0 ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B-County Highway 9533 p YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO 0 YES ® NO 0 YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 960 <br /> 15 Sq.Ft. Sq.Ft.960 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $76,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $122.00 <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 ordin r es. <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATU r 'awn %age/ DATE: <br /> Ordinances.Any unauthorized change from the information <br /> plans submitted will invalidate the permit. _ .m* Z <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY R.•UIRED? DATE ISSUED INI IALS 1st INSPECTION DATE INITIALS <br /> 06/26/2015 SJ W 3 <br /> YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> India..• <br />