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DANE COUNTY ZONING PERMIT DCPZP2016-00082 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MARK A KING (920)241-4202 HART DENOBLE (608) 831-4422 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1105 WINDING WAY 7923 AIRPORT RD <br /> (City,State,Zip) (City,State,Zip) <br /> MIDDLETON, WI 53562 MIDDLETON, WI 53562 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jfranzen @denoblebuilders.corn hart@denoblebuilders.corn <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0808-312-2024-0 TOWN OF SPRINGFIELD 31 NW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 7882 AUTUMN POND TRL <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 14 AUTUMN POND <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1A Residence 1.91 Description:single family residence and porch 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2016-00047 <br /> ❑ Other: , <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 9638 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR ^° TOTAL SQUARE FEET <br /> 7730 <br /> 33 Sq.Ft.2563 Sq.Ft.525 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $640,000.00 <br /> 2 Sq.Ft. 1.142 Sq.Ft. PERMIT FEE <br /> $629.75 <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 <br /> subject 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 <br /> difficult to identify. Failure to comply may result in removal or modification of construction that violates <br /> the law or other penalties or costs. For more information, visit the Department of Natural Resources web <br /> page at 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 SIGNATURE: •wner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or �� <br /> plans submitted will invalidate the permit. �.e r‘4 <br /> 3 4,—/, <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 03/15/2016 SSA1 <br /> ® YES ❑ NO DATE REVIEWED INITIALS _ 2nd INSPECTION DATE INITIALS <br /> Initials: 74 1 ', N ' S <br />