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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1of2 <br /> DCPZP-2016-00153 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> LEE J WALLANDER (608)852-7532 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3020 WYNDWOOD WAY <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Iwalland @amfam.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0911-191-4325-0 TOWN OF BRISTOL <br /> 19 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 3020 WYNDWOOD WAY <br /> subject to field verification.) <br /> - — — <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 75 NORWAY ROAD ESTATES <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> A-1 Agriculture Description:Coy por,open deck&steps to sfr 434- Residential Addition <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ❑ NO ❑ YES ❑ NO ❑ YES ❑ NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 504 <br /> 16 Sq.Ft. Sq.Ft.504 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $20,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $175.60 <br /> I, the undersigned, am the ow4eAof theproperty or an authorized agent acting on behalf of the owner of <br /> the property. I c�rt,ify�th it thte.voo, toJ performed, as part of this zoning permit, will be constructed as <br /> noted on the subTffit ed 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.. k <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,GQrpply removal or modification of construction that violates the law or <br /> other penalties or cot t". 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 SIGNATURE: Owner/Agfnt DATE: <br /> Ordinances.Any unauthorized change from the information or L?) <br /> plans submitted will invalidate the permit. I / , - _2/_I t <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/07/2016 RLB <br /> g^ ❑ ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initial' / <br />