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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1 oft <br /> DCPZP-2015-00855 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME j yyt G AS PHONE AGENT/CONTRACTOR NAME PHONE <br /> Y (608)469-4799 Sugar Creek Homes) 1, �,C. (608)658-1127 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3(i)►b C 0.0 n'isly G (`G v' 237 Ridge View Trail <br /> (City,State,Zip) + D t', (City,State,Zip) <br /> M Mt∎�0 y , w.- Verona,WI 53593 <br /> E-MAIL ADDRESS s/-- / ? E-MAIL ADDRESS <br /> tmlast @gmail.com J tim.burke @sugarcreek-homes.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0607-264-9330-9 TOWN OF SPRINGDALE 26 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 1915 N KOLLATH RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL REAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture Description:sfr w/cov frt por,3-season por,landing&steps 101 -SFR(detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> El Other: Private 1:- '7!)0) OCit — C <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE 7 WETLAND EC/SW NO. <br /> ❑ YES ® NO El �NO ❑ YES NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 6106 <br /> 20 Sq.Ft.2306 Sq.Ft.3800 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $400,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $507.95 <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 subject <br /> 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 difficult <br /> to identify. Failure to comply may result in removal 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 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 SIGNAT RE: Ow = • • - DATE: <br /> Ordinances.Any unauthorized change from the information or n�� , �/j�� <br /> plans submitted will invalidate the permit. �'1e, )61. 4 <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 10/21/2015 RLB <br /> ❑ YES ® NO DATE�/REVIEWED Nn <br /> INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials 1 1i 0 / P ,-1 <br />