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DANE COUNTY ZONING PERMIT DCPZP 2015-00898 Page 1 of 2 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE THOMAS D HMG (608) 335-9400 YAHARA CONSTRUCTION CO (608) 235-8838 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 3128 WAUCHEETA TRL 147 S BUTLER ST (City.State,Zip) (City,State,Zip) MADISON, WI 53711 MADISON, WI 53703 E-MAIL ADDRESS E-MAIL ADDRESS JSVEUM QYAHARABUILDERS.COM PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0610-051-4206-0 TOWN OF DUNN 5 NE SW PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 3128 WAUCHEETA TRL subject to field verification.) LOT BLOCK I C.S.M.NO.or PLAT NAME 16 WAUCHEETA ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE R-2 Residence .9 Description:ADDITION TO SFR 434- Residential Addition District Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. ❑ Other: Sewer ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION D-Unadopted Subdiv Streets ❑ YES 0 NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ® YES ❑ NO ❑ YES Wa NO ❑ YES ® NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 2315 30 sq.Ft.675 Sq.Ft.540 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $510,000.00 Sq.Ft.800 Sq.Ft. PERMIT FEES.6j 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 SI T RE: ner/Agent DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit. \c3+ t OC 1 S OFFICE USE ONLY (form version 03.00.07) SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 11/05/2015 HJH3 ❑ YES DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: