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DANE COUNTY ZONING ' ERMIT ZONING PERMIT NO. <br /> Page 1nf2 <br /> DCPZP-2015-00479 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JAY W DAMKOEHLER (608)205-9;58 W.E.DAVIES&SONS REMODELING (608)222-6609 <br /> BILLING ADDRESS(Number Street) ADDRESS(Number,Street) <br /> 2663 COUNTY HIGHWAY B 4809 MIDMOOR RD <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON,WI 53589 MONONA, WI 53716 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> WISCONSINGARDEN52 @GMAIL.COM WYNN @WEDAVIES.COM <br /> PARCEL NO TOWNSHIP SECTION 1/4 1/41/4 <br /> 0611-324-8040-0 TOWN OF PLEA'"?NT SPRINGS 32 SE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 2663 COUNTY HIGHWAY B <br /> subject to field verification.) <br /> LOT BLOCK f C.S.M.N. or PLAT NAME <br /> ll METES AND BOUNDS <br /> ZONING DISTRICT ! PARCEL ACREAGE PROPOSED—OJECT: New Structure/Addition CENSUS CODE <br /> A-1 Ex Exclusive Ag 2.075 Description:D:T GARAGE AND REMOVAL OF EXISTING 438-Garage <br /> District IMPERVIOU' <br /> Category 0 Residential ❑ Commercial ❑ Agric'Rural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Septic <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B-County Highway <br /> YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ® YES ❑ NO ❑ YES ® NO ❑ YE. ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 12 sq.Ft. Sq_Ft.1050 1050 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $17,000.00 <br /> 1 Sq Ft S9 Ft PERMIT FEE <br /> $128.75 <br /> I, the undersignec, am the owner of the prope y or an authorized agent acting on behalf of the owner of <br /> the property. I ce lily that the work to be perfo med, as part of this zoning permit, will be constructed as <br /> noted on the subnitted plans and comply with he applicable zoning ordinances. I understand that failure <br /> to comply with any provision or condition of thi permit renders this zoning permit null and void and subjQlct <br /> to enforcement action. <br /> I acknowledge that I am responsible for comp) ing with State and Federal laws concerning construction <br /> near or on wetlands, lakes, and streams. Wetl.nds that are not associated with open water can be difficult <br /> to identify. Failure to comply may result in re •val 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.js or contact the Departmen of Natural Resources Service Center. <br /> I hereby consent lo the entry on the permitted 'remises by Dane County zoning inspectors for the <br /> purposes of determining compliance with the z.ning ordinances. <br /> Owner 8 Agent hereby agree to comply with all Dane County GNATURE: •wne /lent DATE: <br /> Ordinances.Any unauthorized change from the information or f� <br /> plans submitted will invalidate the permit. -.3.),-ZS <br /> Ail <br /> USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/30/2015 HJH3 <br /> ❑ YES ® NO <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: ! <br />