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DANE COUNTY ZONING PERMIT DCPZP-2016-00488 Pagel of <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ARTS CUSTOM DESIGN BUILDER LLC (608)345-0397 King Construction (608)225-0432 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1947 KOLLATH RD W3010 Sand Cave Drive <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA,WI 53593 Belleville, WI 53508 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ahahill @aol.com aking @litewire.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0607-264-9230-0 TOWN OF SPRINGDALE 26 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 1969 N KOLLATH RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 10305 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture CO Description:sfr w/cov frt por,scr por,open deck 101 -SFR(detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: <br /> Private 13-2016-00197 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> ` / ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND / EC/SW NO. <br /> ❑ YES ® NO ❑ YES NO lj YES gi NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 7702 <br /> 35 Sq.Ft.2428 Sq.Ft.4382 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $300,000.00 <br /> 2 Sq.Ft.892 Sq.Ft. PERMIT FEE <br /> $627.65 <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 4 j : : Owne /'g> DATE: <br /> Ordinances.Any unauthorized change from the information o <br /> plans submitted will invalidate the permit. , ©g 030I a(? <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/02/2016 RLB <br /> 4 YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 8-J - l Co P M <br />