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DANE COUNTY ZONING PERMIT DCPZP 20 6-00326 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> WILLIAM J HINNENDAEL (608) 575-0198 HART DENOBLE BUILDERS,INC. (608) 831-4422 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4517 SHOOTING STAR AVE 7923 AIRPORT ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> MIDDLETON, WI 53562 MIDDLETON, WI 53562 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JFRANZEN @DENOBLEBUILDERS.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-054-6156-0 TOWN OF MIDDLETON <br /> 5 SE SE <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4517 SHOOTING STAR AVE <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 106 PRAIRIE HOME ESTATES-1ST ADDITION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture .9 Description:15'x 17'SCREEN PORCH 329 - Other <br /> District <br /> Category Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO C.U.P.NO VARIANCE NO DEED RESTRICTION <br /> E-AII Other <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO <br /> ❑ YES p NO ❑ YES © NO ❑ YES I NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 255 <br /> 14 Sq.Ft. Sq.Ft.255 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $70,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $69.13 <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 SIGNATU E: Own- 'gent DATE: <br /> Ordinances.Any unauthorized change from the information or 411 <br /> plans submitted will invalidate the permit. - (0-17—IA0 <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/06/2016 PMK2 <br /> T(❑AYES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> nitialsl��7 / / r/110' j- 14%-) <br />