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DANE COUNTY ZONING PERMIT DCPZP-2016-00192 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JASON KRATZ (608)217-0461 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7157 PFEIL LN <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE,WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jason.kratz @amerhart.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0911-183-4066-0 TOWN OF BRISTOL 18 SW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7157 PFEIL LN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 46 WINFIELD ESTATES KALLAND ADDN <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> A-1 Agriculture Description:22'x 20'x 9'open deck and to Mr wlsteps 434- Residential Addition <br /> District <br /> Category II Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Other Private <br /> U ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> 0 YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO, <br /> ❑ YES ® NO ❑ YES ❑ NO 0 YES ❑ NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 440 <br /> 9 Sq.Ft. Sq.Ft.440 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $8,000.00 <br /> 1 sq.Ft. sq.Ft. PERMIT FEE$83.00 <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 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 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 SIGNATURE: • • = e e=nt DATE: <br /> Ordinances.Any unauthorized change from the Information or <br /> plans submitted will invalidate the permit. � y— Z 9-7_0ji <br /> OFFICE USE ONLY (form version 03.01,00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/25/2016 RLB <br /> �❑ Y S ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />