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DANE COUNTY ZONING PERMIT DCPZGPERMI-00511 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MIDDLETON, TOWN OF ROBERT FELLER (608)444-6988 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7555 W OLD SAUK RD 901 DEMING WAY <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 MADISON, WI 53717 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> BOB.FELLER @ICONICACREATES.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-174-8503-0 TOWN OF MIDDLETON 17 SE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7440 W OLD SAUK RD <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture 50 Description:PARK STORAGE SHED 12 X 16 328-Other Non-Residential <br /> District <br /> Category ❑ Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ® Other:PARK Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 192 <br /> 9.25 Sq.Ft. Sq.Ft. 192 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $3,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $0.00 <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 <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 Dan: •.my zoning inspectors for the <br /> purposes of determining compliance with the zoning o •' = ices. <br /> Owner&Agent hereby agree to comply with all Dane County S GNAT QVN) ner/• - - • ATE: <br /> Ordinances.Any unauthorized change from the information or . 4....... - <br /> plans submitted will invalidate the permit. id \ 8 I I I(r <br /> OFFICE USE ONLY (form version 03.01.(0) <br /> SURVEY R.p IRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/11/2016 HJH3 <br /> • YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> nitials' 8K(a 4 <br />