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DANECOUNTY ZONING PERMIT ZONING PERMIT NO. Page l oft <br /> DCPZP-2015-00586 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME <br /> LINDAHL LIVING TR,DOREEN F (608)635-7004 HOUSE DOCTORS PHONE <br /> (608) 745-8560 <br /> BILLING ADDRESS(Number,Street) <br /> 1160 BLUEBIRD LN ADDRESS(Number,Street) <br /> W8024 MORSE RD <br /> (City,State,Zip) (City,State,Zip) <br /> ROSELLE, IL 60172 POYNETTE, WI 53555 <br /> ■ <br /> E-MAIL ADDRESS <br /> E-MAIL ADDRESS <br /> TJOHNSON @HOUSEDOCTORSMD.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0610-082-0023-2 TOWN OF DUNN 8 NW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME <br /> 2866 ST.TYPE <br /> (Assignment of new address is ' LAKESIDE ST <br /> subject to field verification.) <br /> LOT (BLOCK C.S.M.NO.br PLAT NAME <br /> 3 1 WAUBESA BEACH-1ST ADDITION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PRi JECT: Alteration to existin buildin <br /> R-3 Residence .142 Description:SFE ADDITION 9 9 CENSUS CODE <br /> District 434- Residential Addition <br /> Category ® Residential 0 Commercial ❑ Agricultkural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Sewer <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. <br /> D-Unadopted Subdiv DEED RESTRICTION <br /> Streets <br /> 0 YES (a NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ® YES ❑ NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR <br /> TOTAL SQUARE FEET <br /> 29 Sq.Ft. Sq.Ft.48 575 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $160,000.00 <br /> 2 Sq.Ft.527 Sq.Ft. PERMIT FEE <br /> $93.13 <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 complyi g 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 i <br /> p difficult <br /> to identify. Failure to comply may result in remoal or modification of construction that violates the law or <br /> other penalties or costs. For more information, vi it the Department of Natural Resources web page at <br /> www.dnr.state.wi.us or contact the Department 0 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 SIG ATii�l*,'T -�•'-nt <br /> Ordinances.Any unauthorized change from the information or DATE: <br /> plans submitted will invalidate the permit. � ,-- <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 07/31/2015 HJH3 <br /> 0 YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: j <br />