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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1of2 <br /> DCPZP-2015-00509 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> STATZ BRO. NC <br /> BILLING ADDRES•(Number,Street) ADDRESS(Number,Street) <br /> 5707 COUN Y HIGHWAY W <br /> (City,State,Zip) (City,State,Zip) <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1'4 1/4 1/4 <br /> 0811-, 51-9500-6 TOWN OF SUN PRAIRIE <br /> 9 NE SE <br /> PROPERTY ADDRESS HOUSE NO ST DIRECTION STREET NAME ST TYPE <br /> (Assignment of new ddress is 5707 COUNTY HIGHWAY VV <br /> subject to field vgIrifkation.) <br /> LOT I BLOCK C.S M NO or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRIC- PARCEL ACREAGE PROPOSED PROJECT New Structure/Addition CENSUS CODE <br /> A-1 EX Exclusi e Ag 39.8 Description on premises sign 329- Other <br /> District <br /> Category j U Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO <br /> 4 other Private <br /> ROAD CLASSIFICATIsN REZONE NO C U.P NO VARIANCE NO DEED RESTRICTION <br /> ❑ YES p NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO <br /> 0 YES NO ❑ YES ® NO 0 YES 0 NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 32 <br /> 6 Sq.Ft. Sq.Ft <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $8,000.00 <br /> 0 Sq Ft Sq.Ft PERMIT FEE <br /> $100.00 <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 wi ih any provision or condition of this permit renders this zoning permit null and void and <br /> subject to ens orcement action. <br /> I acknowledie that I am responsible for complying with State and Federal laws concerning construction <br /> near or on w-tlands, lakes, and streams. Wetlands that are not associated with open water can be <br /> difficult to id:ntify. Failure to comply may result in removal or modification of construction that violates <br /> the law or eat er penalties or costs. For more information, visit the Department of Natural Resources web <br /> page at .dnr.state.wi.us or contact the Department of Natural Resources Service Center. <br /> I hereby c.'n'.ent to the entry on the permitted premises by Dane County zoning inspectors for the <br /> purposes if •etermining compliance with the zoning ordinances. <br /> Owner&Agent, e eby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: <br /> Ordinances.An nauthorized change from the information or - <br /> plans submitte. II invalidate the permit. L-- /0-6" <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUI' I? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 07/10/2015 SSA 1 <br /> S El NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> nitial *1%, - - - <br /> • <br />