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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Pagel of 2 <br /> DCPZP-2015-00616 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> FRANK J ACKER (608)209-8733 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3325 MEADOW RD <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA,WI 53593 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0708-324-8680-1 TOWN OF MIDDLETON <br /> 32 SE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3325 MEADOW RD <br /> subject to field verification.) '31-2.� <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 08430 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> A-1 Agriculture Description:34'x 22'x 16'sddn to exst stor shed 329-Other <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES I❑ NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 16 kt .Y Sq.Ft. Sq.Ft.748 748 <br /> Y PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $18,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $106.10 <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 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 difficult <br /> to identify. Failure to comply may result in removal or modification of construction that violates the law or <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> 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 or i ina ri es. <br /> Owner&Agent hereby agree to comply with all Dane Coun SIG A • r' ner/A. : DATE: _ <br /> Ordinances.Any unauthorized change from the informatlo or ' r„r�I <br /> plans submitted will invalidate the permit. �rf l''( ! IJ✓ <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY IRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/11/2015 RLB <br /> YES ® NO <br /> DATE REVIEWED INITIALS 1 2nd INSPECTION DATE INITIALS <br /> Initial :I 6(Li 16 <br />