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DANE COUNTY ZONING PERMIT DCPZP-2016-00012 Page 1of2 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE MICHAEL G LEEDER (608)575-5237 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 1912 COUNTY HIGHWAY BB (City,State,Zip) (City,State,Zip) DEERFIELD,WI 53531 E-MAIL ADDRESS E-MAIL ADDRESS leed5 @msn.com PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 0711-114-9710-9 TOWN OF COTTAGE GROVE 11 SE SE PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 1912 COTTAGE GROVE RD subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME METES AND BOUNDS ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE R-1A Residence Description:16'x 10'x 12'res stor shed 329-Other District Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. ❑ Other Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION B-County Highway DCPREZ-1987-03877 ❑ YES ❑ NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES ® NO ❑ YES ® NO 0 YES ® NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 160 12 Sq.Ft. Sq.Ft.160 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $2,582.00 Sq.Ft. Sq.Ft. PERMIT FEE $62.00 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 SIG ATU : wner/ 3 ent DATE: Ordinances.Any unauthorized change from the information or / i plans submitted will invalidate the permit. 1 • • , l a 9 • OFFICE USE ONLY (form version 03.30.07) SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 01/21/2016 RLB YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials; E` *