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DANE COUNTY ZONING PERMIT DCPZGPERMI00544 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> STEPHEN FLACH JG DEVELOPMENT (608) 437-6181 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 8716 RIDGE DR 4070 E BRIGHAM RD <br /> (City,State,Zip) (City,State,Zip) �q <br /> BELLEVILLE, WI 53508 �'ER6fb , WI 53517 I ` U °L 0 U n d S <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0507-272-9060-8 TOWN OF PRIMROSE 27 NW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 8702 RIDGE DR <br /> subject to field verification.) <br /> LOT BLOCK 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 Ex Exclusive Ag 10.1 Description:single family residence 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private LS C2 O iG - 0 oa O p <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. !DEED RESTRICTION V <br /> C-Town Road <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO ec2016-0230 <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 7049 <br /> 25 Sq.Ft.2275 Sq.Ft.3533 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $770,000.00 <br /> 2 Sq.Ft. 1241 Sq.Ft. PERMIT FEE <br /> $578.68 <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 SIGN• - : 0 • er/Agent DATE: <br /> plans submitted Any unauthorized change <br /> er from the information or�� WZ3i 1p <br /> plans submitted will invalidate the permit. <br /> OFi-uC.E usE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/23/2016 SSA1 <br /> YES ® NO <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initi s: 07\ n /(9 P Ai y <br />