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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Pagelof2 <br /> DCPZP-2015-00480 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> THOMAS M DOYLE Arnim Zellmer (608)655-4093 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 5824 LOCHINVARS TRL 904 Riverview Court <br /> (City,State,Zip) (City,State,Zip) <br /> MARSHALL, WI 53559 Marshall, WI 53559 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> azellmer1@hotmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0812-093-0590-5 TOWN OF MEDINA 9 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 5824 LOCHINVARS <br /> TRL <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 20 SKYLINE TERRACE <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> R-1 Residence Description:21'x 5'ramp;26'x 7'open deck addn to sfr 434- Residential Addition <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> p Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other DCPREZ-1980-01713 <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ® YES 0 NO ❑ YES ❑ NO ❑ YES ❑ NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 8 Sq.Ft. Sq.Ft.286 286 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $24,749.00 <br /> 1 Sq.Ft. Sq.Ft PERMIT FEE <br /> $71.45 <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 subject <br /> 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 difficult <br /> to identify. Failure to comply may result in removal or modification of construction that violates the law or <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> 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 SIGN• RE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. ` ✓ ( (S- <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑ YES ® NO 07/01/2015 RLB <br /> r DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initi, if Z., <br />