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ZONING PERMIT NO. Page 1 of 2 <br /> DANE COUNTY ZONING HERMIT DCPZP-2015-00521 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ALISON PERRY (608)6922187 JG DEVELOPMENT (608)437-6181 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1812 WEST LAWN AVE 4070 E. BRIGHAM ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53711 BLUE MOUNDS, WI 53517 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> KRISTI @JGDEVELOPMENT.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0807-223-8330-0 TOWN OF BERRY 22 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 5395 OTTO KERL RD <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M. 0.or PLAT NAME <br /> 3 CSM 11031 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSE PROJECT: New Structure/Addition CENSUS CODE <br /> RH-4 Rural Homes 20 Description:SFR WITH DECK 101 - SFR (detached) <br /> District <br /> i <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> p Other: Private 13-2015-00223 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.N 3. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 8365 ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ® YES 0 NO ❑ YES ® NO (ES ® NO SE2015-0267 <br /> ❑ <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 23 4744 <br /> Sq.Ft. 1680 Sq.Ft.3064 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR I 3rd FLOOR $379,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $405.80 <br /> I, the undersigned, am the owner of the pro erty 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 with h 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 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 epartment 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 SIGN'I URE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or , <br /> plans submitted will invalidate the permit. MI - 1 - G.. 15 <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY EQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 07/14/2015 PMK2 <br /> ® YES ❑ NO DATE REVIE ED INITIALS Lv 2nd INSPECTION DATE INITIALS <br /> Initials: 1l 1 c) <br /> f <br />