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DANE COUNTY ZONING PERMIT Page 1 of 2 <br /> DCPZP 2015-00736 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> PAULSON DEVELOPMENT LLCP Q ��B,uilding and Design ((608) 212-6934 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4607 OAK SPRINGS CIR PO Box 64 <br /> (City,State,Zip) (City,State,Zip) <br /> DEFOREST, WI 53532 Sun Prairie, Wisconsin 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0911-194-4600-0 TOWN OF BRISTOL 19 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 6910 Oslo LN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 10 LEHMAN'S ADDITION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture Description:single-family dwelling 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: 1 <br /> Private 13-2015-00285 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES 0 NO I ❑ YES ® NO ❑ YES lI NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 4838 <br /> 24 Sq.Ft. 1842 Sq.Ft.2996 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR #Error <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $412.85 <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 co plying 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 r suit in removal or modification of construction that violates <br /> the law or other penalties or costs. For mor information, visit the Department of Natural Resources web <br /> page at www.dnr.state.wi.us or contact the epartment 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 SIGNATURE: Ow rlAgent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. (—(c/S <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 09/15/2015 R W L1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: `5/- <br />