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DANE COUNTY ZONING PERMIT DCPZP-2015-00733 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> BAY VIEW HEIGHTS, INC (608) 873-7725 BRYAN FOLZ (608) 345-2581 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 909 CHARLES LANE 5610 REINER RD <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> BAYVIEWHOMESALES @HOTMAIL.COM BYAN @STERLINGPROPWERTIES.ORG <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0610-262-9000-3 TOWN OF DUNN 26 NW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 716 PIKE LN <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> JI CSM 00765 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-4 Residence 26.0 Description:16'x76'mobile home and decks 101 - SFR (detached) <br /> District <br /> Category ® Residential 0 Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> p Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> A-US or State Highway 1268 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> El YES ® NO 0 YES 0 NO D YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 1388 <br /> 15.0 Sq.Ft. Sq.Ft.1388 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $2,500.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $154.10 <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 www.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 - RE: Own- •ent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. 1 I� <br /> OFFICE USE CNLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED IN INSPECTION DATE INITIALS <br /> 09/15/2015 <br /> YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />