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DANE COUNTY ZONING PERMIT DCPZP-2015-00936 Page 1 of 2 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE LEIBOWITZ REV TR, DALE (608)658-3788 CLEARY BUILDING CORP (608) 845-9700 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 2201 LAKELAND AVE 190 PAOLI STPO BOX 930220 (City,State,Zip) (City,State,Zip) MADISON, WI 53704 VERONA, WI 53593 E-MAIL ADDRESS E-MAIL ADDRESS JGUNDERSON @CLEARYBUILDING.COM PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 0810-191-6089-6 TOWN OF BURKE 19 NE SE PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 4578 DOVETAIL DR subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 9 DOVETAIL SUBDIVISION ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE C-2 Commercial Description:COLD STORAGE GARAGE 329-Other District Category ❑ Residential ® Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. Public ❑ Other: ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION E-AII Other 827 ❑ YES ® NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES NO ❑ YES ❑ NO ❑ YES ❑ NO SE2015-0246 HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 972 18'4" Sq.Ft. Sq.Ft.972 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $75,000.00 1 Sq.Ft. Sq.Ft. PERMIT FEE $350.00 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 SI DRE: Ow -r/Agent DATE: Ordinances.Any unauthorized change from the information or G�V�/! ll�Z �!5 plans submitted will invalidate the permit. �/L OFFICE USE ONLY (form version 03.00.07) SURVEY REQUIRED 7 DATE ISSUED INITIALS 1st INSPECT DATE INITIALS ® YES ❑ NO 11/24/2015 SJW3 DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: I"46 Ip `1l,K