Laserfiche WebLink
DANE COUNTY ZONING PERMIT DCPZP 2016-00616 Pagel of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DCBF TRANSITION TR (608)437-6163 (608)437-6163 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 10123 FERTILE RIDGE RD 10123 FERTILE RIDGE RD <br /> (City,State,Zip) (City,State,Zip) <br /> MOUNT HOREB, WI 53572 MOUNT HOREB, WI 53572 <br /> E-MAIL ADDRESS R k) N I f M H rc N ET. E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0606-224-8690-6 TOWN OF BLUE MOUNDS <br /> 22 SE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 10123 FERTILE RIDGE RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO or PLAT NAME <br /> 2 CSM 08939 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RH-2 Rural Homes 6.67 Description:34'x 50'detached garage 438-Garage <br /> District <br /> Category 0 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 ! l <br /> J ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES 0 NO ❑ YES 0 NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 1700 <br /> 17'-1" Sq.Ft. Sq.Ft. 1700 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $18,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $177.50 <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 hereb y agree to comply with all Dane Count y SI • -E: Owner/Age• DA E: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. . , A A C C —/6 <br /> OFFICE USE ONLY (form ver-,ion 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 09/19/2016 DJ E1 <br /> ❑ NO DATE REVIEWED INITIALS I\r 2nd INSPECTION DATE INITIALS <br /> Initials: , g 9 `� 16 Q <br /> 1 <br />