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07-21-15; 11 :43AM; 2671540 ; # 2/ 7 <br /> vu r. LI. LUI.) I I . VYnlYI • rio. MO r. IU <br /> DANE COUNTY ZONING PERMIT DCPZP12015-00551 . c.,,,,; t of, <br /> OWNER INFORMATION AGLN1(CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME • PHONE <br /> PATRONS MERCANTILE COOPERATIVE (608)437-5536 <br /> BILL'IN0 ADDRESS(Number,Street) ADDRESS(Number.Shoal) <br /> PO BOX 230 <br /> (City,Slate,Zip) (City.Stela,Zip) . <br /> MT HOREB, WI 63572 . <br /> E.MMIL ADDRESS E-MAIL ADDRESS <br /> rnr.;:l I No TOWNSHIP SECTION 114 1/41/4 <br /> 0806-154-9280-1 TOWN OF MAZOMANiE 16 SE SW <br /> PROPERTYADCRE55 HOUSE NO. ST.DIRECTION STREET NAME TV.TYPE <br /> (Assignment of stew address is 10216 US HIGHWAY 14 <br /> suboo to held vsrlfiotllon.) <br /> LOT BLOCK 1C.S.M.NO.or PLAT NAME <br /> I METES AND BOUNDS <br /> ZONING OtSTRICT PARCEI.ACREAGE PROPOSED PROJECT: New Sttuature/Addltlon CENSUS CODE <br /> C-2 Commercial 5 Desciphiarrdryer 328.Other Non-Residential <br /> District <br /> Category ❑ Residential ® Commerdal ❑ Agrleutlurel SEWER SANITARY PERMIT NO. <br /> El aver Private <br /> ROAD CLASS FICATION REZONE NO. 'C_U.P.NO. --.. VARIANCE NO, DEED RESTRICTION l <br /> . A-US or Stale Highway. . 1329 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND SC/SW NO. <br /> 0 YES )a NO ❑ YES ® NO El <br /> 0 No <br /> ec2015-0194/ewm2015.0196 <br /> 1 HEIGHT(In Feet) BASEMENT let FLOOR TOTAL SQUARE FEET <br /> 113 <br /> 88 sq.FL Sq.Fr.113 <br /> PROJECT COST <br /> NO.OF STORIES ens FLOOR 3rd FLOOR $0.00 <br /> 1 Sq.PI. Sq.P1. PERMIT Fite <br /> $200.00 <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 with any provision or condition of this permit renders this zoning permit null and void and <br /> subject 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 <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 /> Oernor a Agent hereby agree to comply with all Dane County g NAT : Owner! �. t ATE: <br /> Ordinano unauthorized ee.Any unauorized change from the Information or <br /> plans submitted will invalidate the permit. 1 ' l .1� N` 7 al /5 <br /> OFFICE USE ONLY (fart)v.,(4,iun 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INIT1ALd 1St INSPECTION DATE INITIALS <br /> YB8 ® NO 07/21/2015 SCWI <br /> IfIN �� DATE REVIEWED ^ �� INITIALS � 2nd INSPECTION DATE INITIALS <br />