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DANE COUNTY ZONING PERMIT DCPZP-2015-00674 Pagel oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> Z & L PROPERTIES LLC (608)437-9595 JAMES LEUZINGER (608)220-7448 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 8854 OFFERDAHL RD 1204 GREEN VALLEY RD <br /> (City,State,Zip) (City,State,Zip) <br /> MT HOREB, WI 53572 MT HOREB, WI 53572 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jamesl @premierbuildingsolutions.biz jamesl •rem ierbuildingsolutions.biz <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0606-131-9910-0 TOWN OF BLUE MOUNDS <br /> 13 NE SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2581 STATE HIGHWAY 92 <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 1 CSM 13959 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> LC-1 Limited 4.20 Description:office building 324- Offices <br /> Commercial Dist <br /> Category ❑ Residential ® Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. , <br /> Private 13-2015-00239 <br /> ❑ Other <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.ND. VARIANCE NO. DEED RESTRICTION <br /> A-US or State Highway 10791 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR ya co V TOTAL SQUARE FEET Lid. G 0 <br /> .4140' <br /> 20'-4" Sq.Ft. Sq.Ft, . .4e r <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $125,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $450.00 <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 performed, as part of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply with 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 complying with State and Federal laws concerning construction <br /> near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be <br /> difficult to identify. Failure to comply may result 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■ ww.dnr.state.wi.us or contact the Department 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 SI ' TURE: Own, gent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. WI 8 �7- o 1S <br /> OFFICE IJSE ONLY (form version 03.00.07) <br /> SURVEY R-• IR ,? DATE ISSUED 'NITIALS 1st INSPECTION DATE INITIALS <br /> • YES ® NO 0 8127/2 01 5 SSA1 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initial 3 I - 1 P►v1 K <br />