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DCPZP-2016-00174
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DCPZP-2016-00174
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4/27/2016 4:22:06 PM
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DCPZP-2016-00174
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DANE COUNTY ZONING PERMIT Page 1of2 <br /> DCPZP-2016-00174 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> SEAN D O'ROURKE (608) 224-3636 RIDGETOP EXTERIORS (608) 249-0831 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 524 CHRISTIANSON AVE 4620 DOVETAIL DR <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53714 MADISON, WI 53704 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0710-051-0665-1 TOWN OF BLOOMING GROVE 5 NE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 524 CHRISTIANSON AVE <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 403 GALLAGHER, CLYDE A PARK SUBDIVISION- <br /> ZONING DISTRICT PARCEL ACREAGE <br /> PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> R-4 Residence 0.119 Description:accessory structure deck replacement(includes primary 329-Other <br /> District structure rear stair replacement) <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> 0 Other: <br /> Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> D-Unadopted Subdiv Streets 757 ❑ 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 /> 54 <br /> Sq.Ft. Sq.Ft.54 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $1,750.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $54.05 <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 /> i _ <br /> Owner&Agent hereby agree to comply with all Dane County IG�,AT E: 0 gent - DATE: <br /> Ordinances.Any unauthorized change from the information or /�� <br /> plans submitted will invalidate the permit. ner /-7Y-/G <br /> OFFICE USE ONLY (form version 03.01.00) <br /> X SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/18/2016 SJ W 3 <br /> ❑I YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials:/e77 <br />
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