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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1 of 2 DCPZP-2015-00483 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE KATHERINE J KASUBASKI (608)268-6333 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 5483 WINDRIDGE RD (City,State,Zip) (City,State,Zip) OREGON,WI 53575 E-MAIL ADDRESS .E-MAIL ADDRESS kkasubaski @gmail.com PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0509-153-2646-4 TOWN OF OREGON 15 SW NW PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of newaddressls 5483 WINDRIDGE RD subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 16 WINDRIDGE ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Additlon CENSUS CODE R-1 Residence Description:8'x 8'x8'chix coop 328-Other Non-Residential District w Category ❑ Residential M0 Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. Private ® Other: ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION E-All Other DCPREZ-2373 ❑ YES ❑ NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES ® NO ❑ YES NO ❑ YES NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET ^ I 8 Sq.Ft. Sq.Ft.64 (w^Y PROJECT COST •- NO.OF STORIES 2nd FLOOR 3rd FLOOR ''#Erc'Q // 000 1 Sq.Ft. Sq.Ft. PERMIT FEE $15.00 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure to comply with any provision or condition of this permit renders this zoning permit null and void and subject to enforcement action. I acknowledge that I am responsible for complying with State and Federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources web page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the purposes of determining compliance with the zoning ordinances. Owner&Agent hereby agree to comply with all Dane County SIG ' T -E: Owner/Ag•n DATE Ordinances.My unauthorized change from the information or , plans submitted will Invalidate the permit. 'i/`A i a i S r . .. : 1 , OFFICE JSE ONLY (form version 03.00.07) SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 4 / ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: )( YES ? ^d ^ lS P M 1