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DANE COUNTY ZONING PERMIT ZONING ERMIT0556 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JESSICA DERN (608)438-4574 ENCORE HOMES (608) 836-9601 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 546 LEXINGTON DR 6840 SCHNEIDER RD <br /> (City,State,Zip) (City,State,Zip) <br /> OREGON, WI 53575 MIDDLETON, WI 53562 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JDERN @UWHEALTH.ORG EHOKSBERGON @ENCOREBUILDSMADISON.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0611-321-8820-0 TOWN OF PLEASANT SPRINGS <br /> 32 NE NW <br /> PROPERTY ADDRESS HOUSE NO, ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 1781 OAKVI EW DR <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 13998 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-2 Residence .483 Description:SFR 101 - SFR (detached) <br /> District <br /> Category ® Residential J Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> 0 Other: <br /> Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 1603 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES ® NO 0 YES 0 NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 3835 <br /> 24.5 Sq.Ft.959 Sq.Ft. 1945 <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $315,966.00 <br /> 2 Sq.Ft.931 Sq.Ft. PERMIT FEE <br /> $337.63 <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 I NATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or 24^20)6 <br /> plans submitted will invalidate the permit. v� <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ® YES NO 08/26/2016 HJH3 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br />