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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1of2 <br /> DCPZP-2015-00048 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> CITY OF MADISON WATER UTILITY MADISON WATER UTILITY (608)266-4653 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> WATER TOWER# 113 119E OLIN AVE 119E OLIN AVE <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53713 MADISON, WI 53713 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ALARSON @MADISONWATER.ORG <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0809-253-0094-1 25 <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 1352 Northport DR <br /> subject to field verification.) <br /> C.S.M.NO.or PLAT NAME <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> Description:AHLZ Replacement of City of Madison Water Tower 325-Public Works <br /> #113 <br /> Category ❑ Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ® Other:UTILITY Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 3662 <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 /> 130 Sq.Ft. Sq.Ft. <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR #Error <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 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 SIGNATU' E: 0, . - - • -nt DATE:' <br /> Ordinances.Any unauthorized change from the information or f <br /> plans submitted will invalidate the permit. l *' 0J/1 <br /> OFFICE USE ONLY s �"' (form jversion 03.00.07) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 02/10/2015 HJH3 <br /> • YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials:,5jp 5 /eh ✓" <br /> / )4. <br />