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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Pagelof2 <br /> DCPZP-2015-00533 <br /> • <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> LAWRENCE J OZERS (608)843-0490 <br /> BILLING ADDRES,6(Number,Street) ADDRESS(Number,Street) <br /> 3544 TIMBER LN <br /> (City,State,Zip) (City,State,Zip) <br /> CROSS PLAINS,WI 53528 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Iarryohome@gmail.com <br /> PAF.CEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-303-9081-9 TOWN OF MIDDLETON 30 SW SW <br /> PROPERTY AD DRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of niw address is 3544 TIMBER LN <br /> subject to field vehfI ation.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 3 CSM 05421 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture Description:22'x 16'x 12'scr gaz 329-Other <br /> District. <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> [ ocner: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ❑ NO ❑ YES ❑ NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 352 <br /> 12 Sq.Ft. Sq.Ft.352 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $20,000.00 <br /> Sq.Ft. Sq.Ft. PERMIT FEE <br /> $76.40 <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.statp.wi.us or contact the Department of Natural Resources Service Center. <br /> I hereby coisent 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'TU-E: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or i <br /> plans submittec will invalidate the permit. x / '�b/"K <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 07/16/2015 RLB <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Inicialsl( <br />