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DANE COUNTY ZONING PERMIT DCPZP-2015-00970 Page oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> HOMES FOR OUR TROOPS INC (508) 967-9009 <br /> BILLING ADDRESS(Number.Street) ADDRESS(Number.Street) <br /> 6 MAIN ST <br /> (City.State,Zip) (City,State.Zip) <br /> TAUNTON, MA 02780 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JMUSE @HFOTUSA.ORG <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0510-352-9555-0 TOWN OF RUTLAND <br /> 35 NW SE <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3586 OLD STAGE RD <br /> subject to field verification.) <br /> LOT BLOCK C S M NO or PLAT NAME <br /> 2 CSM 13829 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT. New Structure/Addition CENSUS CODE <br /> RH-1 Rural Homes 3.8 Description:SFR WITH FRONT AND REAR PORCH. 101 -SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2015-00373 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO C U.P NO VARIANCE NO DEED RESTRICTION <br /> C-Town Road 10740 <br /> YES 0 NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO <br /> YES 0 NO ❑ YES ® NO El YES ® NO EC2015 0441 <br /> Li <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 3600 <br /> 23 Sq.Ft. Sq.Ft 3600 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $250,000.00 <br /> 1 Sq Ft. Sq.Ft. PERMIT FEE <br /> $320.00 <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 SIGN U' Owner/Agent ,/ DATE: <br /> plans submitted Any will invalidate the from the information or / f4 j"1 / I l //6 <br /> plans submitted will invalidate the permit. � � P �� <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 12/17/2015 P M K2 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials. <br />