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DANE COUNTY ZONING PERMIT DCPZP2015-00515 Page 1 of 2 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE BRIAN R HALVENSLEBEN (608) 395-8445 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 4370 BENT GRASS CT (City,State,Zip) (City,State,Zip) WINDSOR, WI 53598 E-MAIL ADDRESS E-MAIL ADDRESS brhhaw @yaF oo.corn PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 0910-293-6375-0 TOWN OF WINDSOR 29 SW SE PROPERTY ACDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of n tw address is 4370 BENT GRASS CT subject to field verifltation.) LOT BLOCK C.S.M.NO.or PLAT NAME 35 PRAIRIE CREEK SUBDIVISION ZONING DISTRIC— PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE R-4 Residence .31 Description:deck 434- Residential Addition District Category Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. Public Other ROAD CLASSIFIC\TIDN REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION E-All Otier 9079 ❑ YES ® NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES la NO ❑ YES ® NO ❑ YES ® NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 396 Sq.Ft. Sq.Ft.396 PROJECT COST NO OF STORIES 2nd FLOOR 3rd FLOOR $2,300.00 0 Sq.Ft. Sq.Ft. PERMIT FEE $79.70 I, the uncle's gned, am the owner of the property or an authorized agent acting on behalf of the owner of the properly. 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 heleby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: 7 Ordinances.Any will invalidate change from the information or / , . /f�� /3- lane submitted will invalidate the permit. 1 ` 7- /c OFFICE USE ONLY (form version 03.00.07) SURVEY REQUIPED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 07/13/2015 SC W 1 ❑ YJ7 ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: g I' f I 1 1 1t