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DANE COUNTY ZONING " ERMIT DCPZP-2015-00617 Page 1 of 2 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> STEPHEN A RAFFEL (608) 798 '316 MICHAEL F. SIMON BUILDERS (608) 849-5918 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7770 NOLL VALLEY RD 817 S. DIVISION STREET <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> HRAFFEL @CHARTER.NET TD @SIMONBUILDS.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0708-313-0721-0 TOWN OF IDDLETON 31 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTIO STREET NAME ST.TYPE <br /> (Assignment of new address is 7770 NOLL VALLEY RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M. O.or PLAT NAME <br /> 21 NOLL VALLEY <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> A-1 Agriculture 3.5 Description: OME ADDITION 434- Residential Addition <br /> District <br /> Category ® Residential ❑ Commercial ❑ Ag icultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: <br /> Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.Ni'. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLA D EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ ES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 1246 <br /> 14 Sq.Ft.441 Sq.Ft.806 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $289,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $143.45 <br /> I, the undersigned, am the owner of the pro.-rty or an authorized agent acting on behalf of the owner of <br /> the property. I certify that the work to be pe ormed, as part of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply wi,h the applicable zoning ordinances. I understand that failure <br /> to comply with any provision or condition of 'his permit renders this zoning permit null and void and <br /> subject to enforcement action. <br /> I acknowledge that I am responsible for com•lying with State and Federal laws concerning construction <br /> near or on wetlands, lakes, and streams. W:tlands that are not associated with open water can be <br /> difficult to identify. Failure to comply may re-ult 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 permitt-• 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 SIGN• -E: 0 ``c eigent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. I I i ,,�(IA I 8 I( d k O - <br /> OFF CE USE ONLY (form version)3.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/11/2015 PM <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 17-0 ty(1 t <br />