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DANE COUNTY ZONING PERMIT DCPZP 2015 00848 Page 1 oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> Tyson Bryant (608)203-5512 Hart DeNoble Builders Inc. (608) 831-4422 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7562 Red Fox Trail 7923 Airport Road <br /> (City,State,Zip) (City,State,Zip) <br /> Madison, WI 53717 Middleton, WI 53562 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> tysonbryant @hotmail.com hart@denoblebuilders.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0808-303-7004-0 TOWN OF SPRINGFIELD 30 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTICN STREET NAME ST.TYPE <br /> (Assignment of new address is 7822 Autumn Pond TRAIL <br /> subject to field verification.) <br /> LOT BLOCK 1 C.S.M. NO.or PLAT NAME <br /> 4 AUTUMN POND <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1 Residence 4.954 Description:sfr w/covered porch and deck 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: <br /> Private 13201500337 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 9638 0 YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES 0 NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 7724 <br /> 20 Sq.Ft.2501 Sq.Ft.3783 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $675,000.00 <br /> 2 Sq.Ft. 144) Sq.Ft. PERMIT FEE <br /> $629.30 <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 SIGNATURE: a wner/Agent R'TE: <br /> Ordinances.Any unauthorized change from the information or � / <br /> plans submitted will invalidate the permit. Ie . .e /0 /G /S <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 10/16/2015 SC W 1 <br /> ❑i ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials:t /f�LJ VA loi ' s--7 <br />