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DANE COUNTY ZONING PERMIT DCPZG PERMI-00282 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> R&R PROPERTIES OF MADISON LLC (608) 212-2380 DAVE ROBERT (608)444-2273 <br /> ■ <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1625 WALDORF BLVD UNIT#302 P.O. BOX 45260 <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53719 MADISON, WI 53744 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> micheb @aol.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-344-9360-2 TOWN OF MIDDLETON 34 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 8272 MID TOWN RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 02086 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture 1.0 Description:lin ground pool 329-Other <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.N . VARIANCE NO. DEED RESTRICTION <br /> C-Town Road ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES ® NO ❑ YES ® NO ❑ }!ES ® NO <br /> I <br /> HEIGHT(In Feet) BASEMENT I 1st FLOOR TOTAL SQUARE FEET <br /> 504 <br /> 0 Sq.Ft. ''I Sq.Ft. <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $10,000.00 <br /> 0 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $87.80 <br /> I <br /> I, the undersigned, am the owner of the pro erty or an authorized agent acting on behalf of the owner of <br /> the property. I certify that the work to be pe ormed, as part of this zoning permit, will be constructed as <br /> noted on the submitted plans and comply with h the applicable zoning ordinances. I understand that failure <br /> to comply with any provision or condition of his 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 nformation, visit the Department of Natural Resources web <br /> ww <br /> page at w .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 Si -TURE: Owner/•g-nt DATE: <br /> Ordinances.Any unauthorized change from the information or ' <br /> plans submitted will invalidate the permit. i ', 4P— 'il ' OS/). I <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 05/23/2016 SSA1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 5( c' <br />