Laserfiche WebLink
,♦ <br /> DANE COUNTY SHORELAND ZONING PERMIT ZONING PERMIT NO. Page 1 of 2 <br /> DCPSHL-2016-00049 <br /> t. OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ANDERSON TR, JUDY ANN (815)298-6866 Am be ofj Pr idq c, L/G 115, ci�] 1 s7 -) <br /> BILLING ADDRESS(F..rrtar Stree,) ADDRESS(Number,Street) L Vl sT <br /> 42531 N SPUR CROSS RD II \ W t l k Lc -1-- - — <br /> (City,State,Zip) (City,State,Zip) <br /> CAVE CREEK, r‘L 85331 C-0 L-FaX � IlA � <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JANDERSONAUTO @YAHOO.COM Kur , '-fl,, <br /> brl _ eS , u <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0611-191-5347-7 1 TOWN OF PLEASANT SPRINGS 19 NE SW <br /> PROPERTY AD9RES&- HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2315 WILLIAMS POINT DR <br /> subject to field verification.) 1 <br /> I LOT ."=. , I C.S.M.NO.or PLAT NAME <br /> 47 I WILLIAM'S POINT- <br /> ZONING DISTRICT I PARCEL SQ FOOTAGE PROPOSED PROJECT: Alteration to existing building <br /> R-3 Residence Description:REPLACEMENT OF LAND BRIDGE/WALKWAY <br /> District ! <br /> PROJECT INFORMATION App for Walkway/Stairs; SEWER <br /> Sewer <br /> REZONE NO. C.U.P.NO VARIANCE NO DEED RESTRICTION <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND 1, <br /> ® YES ❑ NO YES ® NO 0 YES ® NO ^� <br /> Existing Impervious Proposed Impervious <br /> Sq Sq.Ft. <br /> Setback from Ordinary High Wale:.J;ar Water Body Name <br /> 30 I LAKE KEGONSA PERMIT FEE <br /> $150.00 <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 wi 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 compiy with all Dane County SIGNA URE: Ow er/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted wii!invalidate the permit. `lcf'� <br /> am i` , 1 • A, . Ho <br /> 7MB <br /> _ r:.4 - OFFICE USE ONLY <br /> ;GATE ISSUED <br /> (form version 01.01.00) <br /> INITIALS INSPECTION DATE INITIALS <br /> 07/13/2016 HJH3 <br /> - -E REVIEWED INITIALS <br />