Laserfiche WebLink
DANE COUNTY ZONING PERMIT DCPZGPERMI-00800 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ROJO REV TR, JOSE & MARY (608)448-5077 MEIGS INC. (608) 767-2729 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 5556 SURREY LN 1527 US HIGHWAY 14 <br /> (City,State,Zip) (City,State,Zip) <br /> WAUNAKEE, WI 53597 BLACK EARTH, WI 53515 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> SOLOMIO0415 @GMAIL.COM DAVE @MEIGSBUILDS.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0807-124-8000-5 TOWN OF BERRY <br /> 12 SE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 5991 WHIPPOORWILL RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Ex Exclusive Ag 40 Description:30'X 10'RUN-IN SHED-#2 329- Other <br /> District <br /> Category ❑ Residential ❑ Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 2273 <br /> 0 YES 0 NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ® NO ❑ YES ® NO ❑ YES 1 NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 300 <br /> 9 Sq.Ft. Sq.Ft.300 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR .3rd FLOOR $4,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $72.50 <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 • dinances. <br /> Owner&Agent hereby agree to comply with all Dane County SIG 'E: 0 en/ a DATE: <br /> Ordinances.Any unauthorized change from the information or 7 �� 2 <br /> plans submitted will invalidate the permit. <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 10/02/2015 PMK2 <br /> YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />