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DANE COUNTY ZONING PERMIT ZONING DCPZP-2015-00611 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> WARREN @ ANNE ROSE (608) 886-7233 DAVE HOLBERSLABEN (608) 345-7500 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 36 OAKBRIDGE CT 3162 RIDGEWAY AVE <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53717 MADISON, WI 53704 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> davedhdesign @gmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0808-312-2068-0 TOWN OF SPRINGFIELD 31 NW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7898 AUTUMN POND TRAIL <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 18 AUTUMN POND <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1A Residence 1.8 Description:single family residence and deck 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> p Other: Private 13-2015-00247 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-AII Other 9638 <br /> YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 34 Sq.Ft. 1700 Sq.Ft.3032 7017 <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $500,000.00 <br /> 2 Sq.Ft.2285 Sq Ft. PERMIT FEE <br /> $576.28 <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 all Dane County SI .NATUR • •w'er/'g-, DATE: <br /> Ordinances.Any unauthorized change from the information or j / / r <br /> plans submitted will invalidate the permit /7-75 <br /> OFFICE USE ONLI (form version 03.00.07) <br /> SURVEY REQUIRED 7 DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/10/2015 SSA1 <br /> �❑ YES ® NO DATE REVIEWED INITIALS ,[! 2nd INSPECTION DATE INITIALS <br /> Initials: (1 T(s c416\15 ` J(� <br />