Laserfiche WebLink
DANE COUNTY SHORELAND ZONING PERMIT ZONING PERMIT N0. Page 1 of 2 <br /> DCPSHL-2016-00072 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> STEVEN J PARKINSON (608) 335-2598 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 6872 BRIAR LN <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> S PAR KI N S 16 @G MAI L.CO M <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0911-193-9861-8 TOWN OF BRISTOL 19 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 6872 BRIAR LN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 06066 <br /> ZONING DISTRICT PARCEL SQ FOOTAGE PROPOSED PROJECT: New Structure/Addition <br /> A-1 Agriculture 53679 Description:DETACHED RESIDENTIAL GARAGE 12 X 20 •_• <br /> District <br /> PROJECT INFORMATION App for a Residential Structure, SEWER <br /> Septic <br /> REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND <br /> YES ❑ NO 0 YES IA NO 0 YES ® NO <br /> Existing Impervious Proposed Impervious <br /> Sq.Ft 4629 sq.Ft.4869 ' <br /> Setback from Ordinary High Water Mark Water Body Name <br /> 260 UNNAMED 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 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 IGN - -E: Owner/•gem D•TE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. 7�/l�l�✓!� <br /> • <br /> '9 7 l6 <br /> OFFICE USE ONLY (form version 01.01.00) <br /> DATE ISSUED INITIALS INSPECTION DATE INITIALS <br /> 09/07/2016 HJ H 3 <br /> DATE REVIEWED INITIALS <br />