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DANE COUNTY ZONING PERMIT ZONING PERMIT NO Page 1 of 2 <br /> DC PZP-2015-00525 <br /> OWNER INFORMATION AGENT,CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> VERIDAN HOMES LLC (608)226-3100 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 6801 SOUTH TOWNE DR <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON,WI 53713 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO TOWNSHIP SECTION 1/4 1/41/4 <br /> 0910-203-2225-0 TOWN OF WINDSOR 20 SW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 4424 DUTCH DIAMOND WAY <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 255 HOLLAND FIELDS-FIRST ADDITION <br /> ZONING DISTRICT P RCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-3 Residence .30 Description:single family residence and deck and porch 101 -SFR(detached) <br /> District <br /> Category la Residential 0 Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Public <br /> 0 Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-AII Other 8893 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES ® NO" 0 YES ® NO 0 YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 3538 <br /> 25 Sq.Ft.990 Sq.Ft.1638 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $225,226.00 <br /> 2 Sq.Ft.910 Sq.Ft. PERMIT FEE <br /> $315.35 <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 SIGNATURE!Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the Information or _ , ` 1/�/� <br /> plans submitted will invalidate the permit I `( G <br /> OFFICE USE ONLY (turn) version 03 00.071 <br /> SURVEY REQUIRED? DATE ISSUED INITIALS let INSPECTION DATE INITIALS <br /> 07/14/2015 SSA1 <br /> YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 1 '\\'.aLk Cxy" <br />