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DANE COUNTY ZONING PERMIT DCPZP-2016-00105 Page 1 of 2 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DUNN, TOWN OF (608) 838-1 X181 Town of Dunn (608)838-1081 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4156 COUNTY HIGHWAY B 4156 County Highway B <br /> (City,State,Zip) (City,State,Zip) <br /> MCFARLAND,WI 53558 MCFARLAND, WI 53558 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> bkollenbroich@town.dunn.wi.us <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0610-212-9710-4 TOWN O' DUNN 21 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4156 COUNTY HIGHWAY B <br /> subject to field verification.) <br /> LOT 1BLOCK B C,S.M.Nd.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED RROJECT: New Structure/Addition CENSUS CODE <br /> RH-1 Rural Homes 1.9 Description:Town of Dunn Storage Shed 50 x 100' 325-Public Works <br /> District <br /> Category ❑ Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ® Other.GOVERNMENT USE Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 4767 845 3673 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO <br /> ❑ YES fa NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 5000 <br /> 19.5 Sq.Ft Sq.Ft 5000 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $105,000.00 <br /> 1 Sq.Ft Sq.Ft. PERMIT FEE <br /> $0.00 <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 perfo med, 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 SIGNATIJRE:Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the Information or t 3 1� <br /> plans submitted will invalidate the permit. / ,A1.,,,,+ 7-'j <br /> OFFICE USE ONLY (form version 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 03/24/2016 HJH3 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: k,, <br />