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1 <br /> ZONING PERMIT NO. Page 1 of 2 <br /> DANE C1• U �TY SHORELAND ZONING PERMIT DCPSHL-2015-00063 <br /> - j OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DAWN P MC EE ! (608)235-0923 VOYAGER BUILDERS (608)825-4545 ' <br /> BILLING ADDRES1 (Numb ,Street) ADDRESS(Number,Street) <br /> 3598 SCOVI CT,' 1500 WEST MAIN ST <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0610-234-4525-0 TOWN OF DUNN 23 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 3598 SCOVILL CT <br /> subject to field verification.) <br /> LOT C.S.M.NO.or PLAT NAME <br /> 2 1BLOCK CSM 12333 <br /> ZONING DISTRICT PARCEL SQ FOOTAGE PROPOSED PROJECT: New Structure/Addition <br /> R-3 Residence 7276 Description:replacement of sidewalk and decks <br /> District ,i1/1s <br /> PROJECT INFORMATION App for a Residential Structure; SEWER 441 <br /> Sewer <br /> REZONE NO. C.U.P.NO. VARIANCE NO. L' �� <br /> 937 DEED RESTRICTION ¢�y�t �� <br /> ❑ YES ® NO �,.', as <br /> SHORELAND FLOOD ZONE WETLAND + ,r <br /> ® YES D NO ❑ YES ® NO fl YES ® NO -T Vi s: <br /> Existing Impervious Proposed Impervious 2,0 ry e, rx <br /> Sq.Ft.138 Sq.Ft.138 A <br /> Setback from Ordinary High Water Mark Water Body Name , " 4,e;".. " ^. <br /> 75 KEGONSA PERMIT FEE <br /> $150.00 <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 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 ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County SI TU- : Ow -r/A en DA E: <br /> Ordinances.Any unauthorized change from the information or '�l . r7 r— 3 <br /> plans submitted will invalidate the permit. G `./ ,<6, v <br /> OFFICE USE ONLY (form version 01.01.00) <br /> DATE ISSUED INITIALS INSPECTION DATE INITIALS <br /> 08/06/2015 SSA1 <br /> DATE REVIEWED INITIALS <br />