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DANECOUNTY ZONING PERMIT ZONING PERMIT NO. Page l of 2 DCPZP-2016-00263 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE ZANA BAJALAN (414)581-7719 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 408 POWERS AVE (City,State,Zip) (City,State,Zip) MADISON, WI 53714 E-MAIL ADDRESS E-MAIL ADDRESS ZANAJASSIM@GMAIL.COM PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 0710-051-2811-9 TOWN OF BLOOMING GROVE 5 NE NW PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 408 POWERS AVE subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 11 6 GALLAGHER, ELISHA L PLAT-1ST ADDITION ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE R-3 Residence .12 Description:REPLACE AND ENLARGE EXISTING DECK 434- Residential Addition District Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. Public ❑ Other: ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION D-Unadopted Subdiv 768 Streets ❑ YES ® NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 142 4 Sq.Ft. Sq.Ft. 142 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $1,000.00 1 Sq.Ft. Sq.Ft. PERMIT FEE $61.00 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure to comply with any provision or condition of this permit renders this zoning permit null and void and subject to enforcement action. I acknowledge that I am responsible for complying with State and Federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources web page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the purposes of determin n j compliance with the zoning ordinances. Owner&Agent hereby agree to comply with all Danis County SIGNATURE: Owner ge% DATE: Ordinances.Any unauthorized change from the information or / 7.1 // plans submitted will invalidate the permit. �� !6 OFFICE USE ONLY (form version 03.01.00) • SURVEY REQUIRED? DATE ,ISSUED t INITIALS 1st INSPECTION DATE INITIALS 05/16/2016 HJH3 ❑ YES la NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS