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DANE COUNTY ZONING ' ERMIT ZONING PERMIT NO. Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> PAUL P ROLTGEN (262) 364 8928 ULTIMATE CONSTRUCTION (608) 825-4633 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4907 KRAMER CT 4827 PIERCEVILLE RD <br /> (City,State,Zip) (City,State,Zip) <br /> COTTAGE GROVE, WI 53527 COTTAGE GROVE, WI 53527 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> SAF @ULTUSA.BIZ <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0811-342-9710-1 TOWN OF '.UN PRAIRIE 34 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTI.N STREET NAME ST.TYPE <br /> (Assignment of new address is 4907 KRAMER CT <br /> subject to field verification.) <br /> LOT BLOCK C.S.M. 0.or PLAT NAME <br /> 2 CSM 01084 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSE"PROJECT: Alteration to existing building CENSUS CODE <br /> A-1 Ex Exclusive Ag 1 Description: ARAGE+REAR DINING ROOM AND SCREEN 434- Residential Addition <br /> District PORCH A•DN <br /> Category ® Residential ❑ Commercial ❑ A.ricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.N.. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> 0 YES ® NO <br /> SHORELAND FLOOD ZONE WETLA D EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO 0 ES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 1600 <br /> 24 Sq.Ft. Sq.Ft. 1040 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $96,000.00 <br /> 2 Sq.Ft.56, Sq.Ft. PERMIT FEE <br /> $170.00 <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 ih 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 permitte. 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 I SIG•.•TURE: ! . ner - . - DATE: <br /> Ordinances.Any unauthorized change from the information or ,"` <br /> plans submitted will invalidate the permit. !MIL. aL 111/ //' <br /> / <br /> OFFILE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 'elli.111wInNSPECTION DATE INITIALS <br /> 09/01/2015 SJW3 <br /> ® YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />