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DANE COUNTY ZONING ' ERMIT DCPZG PERMIT ON0644 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> RANDY PETERS (608)669 7808 MARTEN BUILDING AND DESIGN 608-212 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1168 ST ALBERT THE GREAT DR PO BOX 64 <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> RLPETERS1 @FRONTIER.COM RANDY @MARTENBUILDING.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0911-121-0197-0 TOWN 0 BRISTOL 12 NE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTI• STREET NAME ST.TYPE <br /> (Assignment of new address is 1678 ESKER TRL <br /> subject to field verification.) <br /> LOT BLOCK C.S.M. O.or PLAT NAME <br /> 57 DRUMLIN CREEK <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSE PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture 0.97 Description:'4X32 residential out building 438-Garage <br /> District <br /> Category ® Residential 0 Commercial 0 A. icultural SEWER SANITARY PERMIT NO. <br /> ❑ Other. Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.No. VARIANCE NO. DEED RESTRICTION <br /> E-AII Other <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLA D EC/SW NO. <br /> 0 YES ❑ NO ❑ YES IZI NO 0 ES ® NO <br /> DCPSHL-2015-00008 <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 768 <br /> 14.6 Sq.Ft. Sq.Ft.768 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $30,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $107.60 <br /> I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of <br /> the property. I certify that the work to be pe ormed, as part of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply wi Ih the applicable zoning ordinances. I understand that failure <br /> to comply with any provision or condition of t is permit renders this zoning permit null and void and <br /> subject to enforcement action. <br /> I acknowledge that I am responsible for come lying with State and Federal laws concerning construction <br /> • <br /> near or on wetlands, lakes, and streams. Wz tlands that are not associated with open water can be <br /> difficult to identify. Failure to comply may re..ult in removal or modification of construction that violates <br /> the law or other penalties or costs. For more information, visit the Department of Natural Resources web <br /> page at www.dnr.state.wi.us or contact the I-partment of Natural Resources Service Center. <br /> I hereby consent to the entry on the permitte• premises by Dane County zoning inspectors for the <br /> purposes of determining compliance with th- zoning ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County IGNATURE: Owner/Agent I ATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. f' C e'-/ ,'L <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED 7 DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/18/2015 SJW3 <br /> ® YES ❑ NO <br /> �+ DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> 4 Initials: .$F' <br /> 1 <br />