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DANE COUNTY ZONING PERMIT DCPZP201600582 Page 1of2 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE WINDSOR QUARRY LLC (608) 234-7093 AMBIANCE HOMES INC. (608) 225-4594 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 4607 OAK SPRING CIR 5833 GRASSLAND TERRACE (City,State,Zip) (City,State,Zip) DEFOREST, WI 53532 MARSHALL, WI 53559 E-MAIL ADDRESS E-MAIL ADDRESS AMBIANCEHOMESINC @CHARTER.NET PARCEL NO. TOWNSHIP SECTION I 1/4 1/4 1/4 0911-184-1533-0 TOWN OF BRISTOL 18 SE NE PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 7218 KALTENBERG PASS subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 13 BURNSON'S RIDGE ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE A-1 Agriculture 1 Description:SFR WITH SCREEN PORCH 101 -SFR (detached) District Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. Private 13-2016-00255 ❑ Other: ROAD CLASSIFICATION 'REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION E-All Other D YES ® NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 5607 21 Sq.Ft.2092 Sq.Ft.3515 PROJECT COST NO OF STORIES 2nd FLOOR 3rd FLOOR $265,000.00 1 Sq.Ft. Sq.Ft. PERMIT FEE $470.53 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure to comply with any provision or condition of this permit renders this zoning permit null and void and subject to enforcement action. I acknowledge that I am responsible for complying with State and Federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources web page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the purposes of determining compliance with the • ing ordinances. Owner&Agent hereby agree to comply with all Dane County T - : Owne ' . •nt DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit. ._ OAN - 1 ,_`_ .11 C\ . (0 . \ OFFICE USE ONLY (form version 03.01.00) SURVEY REQUIRED? DATE ISSUED INITIALS‘ 1st INSPECTION DATE INITIALS 09/06/2016 PMK2 YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials.