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' ZONING PERMIT NO. <br /> DANE COUNTY ZONING PERMIT DCPZP-2015-00737 Page1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> TREVOR BERCEAU (920) 562-8078 BRIO DESIGN HOMES (608)437-6181 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2813 MAPLE GROVE DR 4070 E BRIGHAM RD <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53719 BLUE MOUNDS, WI 53517 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> SARAH.E.BE RC EAU @GMAT L.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0608-262-9571-0 TOWN OF VERONA 26 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2059 COUNTY HIGHWAY PB <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 12360 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RH-1 Rural Homes 2.001 Description:single family residence no deck 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private 13-2015-00275 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B-County Highway 2573 ❑ YES ® NO <br /> SHORE ND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ® NO ❑ YES ® NO ❑ YES I NO SE2015-0323 <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 4245 <br /> 27'-5" Sq.Ft. 1228 Sq.Ft.2069 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $395,000.00 <br /> 2 Sq.Ft.948 Sq.Ft. PERMIT FEE <br /> $368.38 <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 • - IN., '•r a ent ` ATE: ` <br /> plans <br /> Ordinances.Any unauthorized chanpeerm m the information or _ ` " \V ` J 1 T. <br /> tans submitted will invalidate the \ - <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 09/15/2015 SSA1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 1 ' 2nd INSPECTION DATE INITIALS <br /> Initials: 9 —KO,� ' IS P V <br />