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DANE COUNTY ZONING ` ERMIT DCPZP2015-00847 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MELANIE WEINER (608)795-2'.22 Frey Construction (608)795-2922 <br /> BILLING ADDRESS(Number Street) ADDRESS(Number.Street) <br /> 9412 DUNLAP HOLLOW RD 530 Park Ave., <br /> (City,State,Zip) (City State Z°P) <br /> MAZOMANIE,WI 53560 Prairie du Sac, WI 53578 <br /> E-MAIL ADDRESS E-MA L ADDRESS <br /> coryr @freyconstruction.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1I4 <br /> 0907-313-9580-1 TOWN OF -OXBURY 31 SW SE <br /> PROPERTY ADDRESS HOUSE NO ST DIRECTION STREET NAME ST TYPE <br /> (Assignment of new address is 9412 DUNLAP HOLLOW RD <br /> subject to nod verification.) <br /> LOT BLOCK C 5 M N• or PLAT NAME <br /> 1 CSM 02401 <br /> ZONING D•STRICT PARCEL ACREAGE PROPOSED P-OJ£CT New Structure/Addition CENSUS CODE <br /> A-1 Ex Exclusive Ag 4.130 Description de ached garage 434-Residential Addition <br /> District <br /> Category Qt Residential a Commermal ❑ Agric tural SEWER SANITARY PERMIT NO <br /> ❑ Other Private <br /> ROAD CLASSIFICATION REZONE NO CUP NO VARIANCE NO DEED RESTRICTION <br /> C-Town Road <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC•SW NO <br /> D YES ® NO ❑ YES ® NO ❑ YE' ca NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 826 <br /> 13 Sq Ft. Sq Ft.826 <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $80,000.00 <br /> 1 Sq Ft. Sq Ft. PERMIT FE <br /> I, the undersigned, am the owner of the prope y or an authorized agent acting on behalf of the owner of <br /> the property. I certify that the work to be perfo med, as part of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply with he applicable zoning ordinances. I understand that failure <br /> to comply with any provision or condition of thi•• permit renders this zoning permit null and void and subject <br /> to enforcement action. <br /> I acknowledge that I am responsible for comp) ing with State and Federal laws concerning construction <br /> near or on wetlands, lakes, and streams. WO-nds that are not associated with open water can be difficult <br /> to identify. Failure to comply may result in re oval or modification of construction that violates the law or <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> www.dnr.state.wi.us or contact the Departmen of Natural Resources Service Center. <br /> I hereby consent to the entry on the permitted itemises 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 S'GNAYURE• • • en/ •e DATE: <br /> Ordinances.Any unauthorized change from the information or / <br /> plans submitted will invalidate the permit ' to..-J6- /5 <br /> CFFICF USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED 7 DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 1W15/2015 SCW1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> nitials <br />