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DANE COUNTY SHORELAND ZONING PERMIT ZONING PERMIT NO. Page 1of2 DCPSHL-2015-00088 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE AMY S MARTIN (608)235-1868 AMERICAN GARAGE BUILDERS (608)235-1868 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 6335 TOWN HALL DR 1204 ENTERPRISE DR - (City,State,Zip) (City,State,Zip) SUN PRAIRIE, WI 53590 VERONA, WI 53593 E-MAIL ADDRESS E-MAIL ADDRESS PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0911-334-9851-9 TOWN OF BRISTOL 33 SE SE PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 6335 TOWN HALL DR subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 1 CSM 06637 ZONING DISTRICT PARCEL SQ FOOTAGE PROPOSED PROJECT: Alteration to existing building A-1 Agriculture 76209 Description:2 decks+detached garage District PROJECT INFORMATION App for a Residential Structure; SEWER , Septic 15 4 � 4� t :f'$ REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION . ❑ YES ® , NO � �l,. SHORELAND FLOOD ZONE WETLAND y Iri ® YES ❑ NO 0 YES ® NO YES ® NO ` `4 ' M? - ir a - X-A + ice' - � r� 7 l Existing Impervious Proposed Impervious t s * a gz a wog : i w, S .Ft.6620 s Ft.7884 1 Ar 4444'-,44M,0-'-'1,, s ` PI _ ` : , Setback from Ordinary High Water Mark Water Body Name * Pa ��T, `; x ' '. £- :PERMIT FEE 90 BRAZES LAKE � - $150.00 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure to comply with any provision or condition of this permit renders this zoning permit null and void and subject to enforcement action. I acknowledge that I am responsible for complying with State and Federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources web page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the purposes of determining compliance with the zoning ordinances. Owner&Agent hereby agree to comply with all Dane County <`1 TUR • Owner/Agent "ATE: Ordinances.Any unauthorized change from the information o r+ plans submitted will invalidate the permit. `0 ) /5- OFFICE USE ONLY (form version 01.01.00) DATE ISSUED INITIALS INSPECTION DATE INITIALS 10/07/2015 HJH3 DATE REVIEWED INITIALS