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07-21-15; 11 :43AM; 2671540 ; # 4/ 7 <br /> (.4095- -PC-4 -ra2-4E9 t2 Ilu. viL0 r. U <br /> �ul�fl <br /> DANE COUNTY ZONING PERMIT DONINL, 2015 1IT NO.-00549 Pagciut2 <br /> OWNER INFORMATJON AGENTICONI I+ACTOR INFORMATION <br /> OWNER NAME . PHONE AQENT/CONTRACTOR NAME PHONE <br /> PATRONS MERCANTILE COOPERATIVE (608)437-5536 • <br /> SIL4.NV0 ADDRESS(Number,guest) ADDRESS(Number,Street) . <br /> PO BOX 230 <br /> (pry,Stale,ZIp) (City,Stale.Zip) N <br /> . MT HOREB, WI 53572 <br /> r.MAIL ADDRESS • E-MAIL ADDRESS <br /> rARCCL NO. TOWNSHIP SECTION 1/4 114114 <br /> 0806-154-9280-1 TOWN OF MAZOMANIE 16 SE SW <br /> PROPERTY ADUNLSS NOUSE NO. ST.DIRECTION STREET NAME 5T.TYPE <br /> (Assignment of new address is 10216 US HIGHWAY 14 <br /> subject to gold verification.) <br /> LOT ®LOCK I C,S.M.N0,or PLAT NAME <br /> METES AND SOUNDS <br /> INO DISTRICT PARCEL ACREAGE <br /> z0N PROPOSED PROJECT: Now 8tn+oturo/Arldltion CENSUS CODE <br /> 0.2 Commercial 5 . Dasorlpaen:grain bin 328-Other Non-Residential <br /> District <br /> Categoty [] Residential ® Commercial El Agricultural Agricultural SEWER SANrrARY PERI NO. .' <br /> 0 ou,e Private <br /> CLASSIFICATION REZONE NO. C.U.P.N0. VARIANCE NO. DEED RESTRICTION <br /> M1S or Slate Highway 1329 ❑ YES la NO <br /> SStIORELAND FLOOD ZONE WETLAND WSW NO. , <br /> 002015.0194/6m2015-0195 <br /> 0 YES la NO ❑ YES IZ NO ❑ YE$ ® NO <br /> HEIGHT(In Feel) BASEMENT l e1 FLOOR TOTAL SQUARE FEET <br /> 8624 <br /> 120 sq.Ft. Ss.FL 8624 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $1,560,000.00 <br /> Sq.FL eq.Fl. •PERMIT FEE <br /> $3320.00 <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 /> Owner&Agent hereby agree to comply with ail who County (GNAT I ' Owner/4:: : : IATE: <br /> Ordinances.Any unauthorized Mange from the Information or , <br /> piens submitted will Invalidate the permit. id` I/ 7/g-t /'S • <br /> OFFICE USE ON.Y (torsi vi r,iuli 0100.07) <br /> BURVEY REQUIRED 7 DATE ISSUED INIT . 1st INSPECTION DATE . INITIALS <br /> 07/21/2016 SCW1 <br /> 0 YES ® NO DATE REVIteWEO . INITIALS 2nd INSPECTION DATE INITIALS <br /> InitIels� `7 w■ 8- q- pP,K <br />