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DANE COUNTY ZONING PERMIT DCPZP-2015-00511 Page 1 of 2 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> BRIAN M WOLF (920) 843-0202 PAT BYRNES (608)219-7678 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2839 COUN—RY DR 503 5TH ST <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0911-293-6045-1 TOWN OF BRISTOL 29 SW SE <br /> PROPERTY ACDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2839 COUNTRY DR <br /> subject to field vi rification.) <br /> LOT BLOCK C.S.M.NO or PLAT NAME <br /> 5 BROOKS RIDGE <br /> ZONING DISTRIC— PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture 0.665 Description:deck 434- Residential Addition <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> [ Other: Private <br /> • <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO <br /> ❑ YES ® NO ❑ YES 0 NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 288 <br /> 6'-6" Sq.Ft. Sq.Ft. <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $12,000.00 <br /> Sq.Ft. Sq.Ft. <br /> PERMIT FEE <br /> $71.60 <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 <br /> subject to enforcement action. <br /> I acknowlec ge 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 <br /> difficult to identify. Failure to comply may result in removal or modification of construction that violates <br /> the law or other penalties or costs. For more information, visit the Department of Natural Resources web ' <br /> page at 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 t <br /> plans submitted will invalidate the permit. A 7-1c)-1-5 <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED^ DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 07/10/2015 SSA1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: �'S 8 <br />