Laserfiche WebLink
DANE COUNTY ZONING PERMIT DCPZP2016-00583 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DAVID DEWALD (604P/s---,3.55 3 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 11714 MID TOWN RD <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 <br /> E-MAIL ADDR S ^ E-MAIL ADDRESS <br /> 0aV @ trace- Wood, corn <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0608-061-8677-6 TOWN OF VERONA 6 NE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 11714 MID TOWN RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 3 CSM 09156 <br /> ZONING DISTRICT PARCEL AC GE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> RH-2 Rural Homes Description:20 x 26 deck addition 434- Residential Addition <br /> District <br /> Category Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road f/ p 7 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE V WETLAND EC/SW NO. <br /> 0 YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 520 <br /> 10 Sq.Ft. Sq.Ft.520 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $43,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $89.00 <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 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 SIG •T -E: Own- •e, DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit '0/=- - Was ?/7 / <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 09/06/2016 R W L1 <br /> ❑ YES ® NO DATE REVIEWED INITIAL 2nd INSPECTION DATE INITIALS <br /> Initials: 7 ''`C..)^ /Cc rK <br />