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DANE COUNTY ZONING PERMIT DCPZP2016-00249 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> VONDRA LIVING TR (608) 757-4205 Cleary Building (608) 379-0132 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) . <br /> 4444 OAK HILL RD 190 Paoli St., <br /> (City,State,Zip) (City,State,Zip) <br /> OREGON, WI 53575 Verona, WI 53593 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> justin @ddclean.com tleeser @clearybuilding.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 . <br /> 0510-083-9310-7 TOWN OF RUTLAND 8 SW SW . <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4444 OAK HILL RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 06412 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT:'New Structure/Addition CENSUS CODE <br /> RH-2 Rural Homes 4.35 Description:ag accessory building no sanitary fixtures personal 328-Other Non-Residential <br /> District property storage <br /> Category 0 Residential 0 Commercial ® Agricultural SEWER SANITARY PERMIT NO. • <br /> p Other Private no sanitary fixtures <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 5022 p YES ® NO i <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. �+ `!,� / . <br /> 0 YES ® NO 0 YES ® NO 0 YES ® NO - 1 0/C- o rte,J,' l .. -� <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR V TOTAL SQUARE FEET - <br /> 5200 <br /> 22 Sq.Ft. Sq.Ft.5200 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $150,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $440.00 <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 <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 /> Owner&Agent hereby agree to comply with all Dane County -S NATUR • •'ner gent a •TE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. a■ it ik-' 5 1//4 <br /> OFFICE USE ONLY (form r arson 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ® Y S NO 05/11/2016 SCW1 <br /> VD DATE REVIEWED //�� INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: / 6- I - 1C, P <br />