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DANE COUNTY ZONING PERMIT DCPZP-2015-00619 Page 1 of 2 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE VERIDIAN HOMES AB LLC (608)226-3100 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 6801 SOUTH TOWNE DR (City,State,Zip) (City,State,Zip) MADISON,WI 53713 E-MAIL ADDRESS E-MAIL ADDRESS PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 0910-203-2247-0 TOWN OF WINDSOR 20 SW NW PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 4421 DUTCH DIAMOND WAY subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 257 HOLLAND FIELDS-FIRST ADDITION ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE R-3 Residence .24 Description:SFR WITH DECK AND FRONT PORCH 101 -SFR(detached) District Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. ❑ Other: Public 5394 ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION E-AII Other 8893 ❑ YES ❑ NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 4017 24 Sq.Ft.1094 Sq.Ft.1909 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $238,393.00 2 Sq.Ft 1014 Sq.Ft PERMIT FEE $351.28 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure to comply with any provision or condition of this permit renders this zoning permit null and void and subject to enforcement action. I acknowledge that I am responsible for complying with State and Federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources web page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the purposes of determining compliance with the zoning ordinances. Owner&Agent hereby agree to comply with all Dane County SIGN'T -E: ner/Agent DATE: Ordinances.Any unauthorized change from the information or Cy — 1 plans submitted will invalidate the permit. Q OFFICE USE ONLY (form version 03.00.07) SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 08/11/2015 PMK2 00 YES ❑ NO DATE REVIEEyI'ED INITIALS 2nd INSPECTION DATE INITIALS Initials: D Q �IIr