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DANE COUNTY ZONING PERMIT DCPZP201600339 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MIDDLETON,TOWN OF (608)833-4346 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7555 W OLD SAUK RD <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA,WI 53593 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> fhankel@town.middieton.wi.us <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0708-203-6325-0 TOWN OF MIDDLETON 20 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3800 BAY LAUREL LN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 7 SPRUCE HOLLOW <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture 2.5 Description,ground sign 328-Other Non-Residential <br /> District <br /> Category 0 Residential 0 Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> tJ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other <br /> D YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES la NO Ei YES ® NO 0 YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 20 <br /> 5 Sq.Ft. Sq.Ft.20 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $2,000.00 <br /> 0 Sq.Ft. Sq,Ft. PERMIT FEE <br /> $100.00 <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 SIGNAT RE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the Information or <br /> plans submitted will Invalidate the permit. (1. 6 <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/09/2018 SCW1 <br /> 0 YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />