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DANE COUNTY ZONING PERMIT DCPZP-2016-00678 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> RICHARD J FAHEY (608)212-5711 Terrace Custom Builders (608)339-7888 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1984 MANHATTAN DR 1553 11th Drive <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 Friendship,WI 53934 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> mfahey @brucecompany.com terraceoffice @terracehomes.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0508-293-9500-8 TOWN OF MONTROSE 29 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 7532 WALTER RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/AdditIon V CENSUS CODE <br /> A-1 Ex Exclusive Ag 38 Description: \\� n �� ��C�� pQ�C l 101 -SFR (detached) <br /> District .) t� r <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ tee Private 13201500193 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT ' C1 3C0 1st FLOOR ;3 0 0 L/ TOTAL SQUARE FEET [' NO <br /> 14 Sq.Ft.1847 Sq.FL 2740 <br /> 4587 1 I <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $250,000.00 <br /> 1 Sq.Ft. Sq FL PERMIT FEE <br /> $394.03 <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 subject <br /> 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 difficult <br /> to identify. Failure to comply may result in removal or modification of construction that violates the law or <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> 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 Si ATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or ` <br /> plans submitted will invalidate the permit. <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPEC 'N DATE INITIALS <br /> 10/13/2016 SCW1 <br /> ❑ YES ® NO <br /> DATE REVIEWED r INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 1 ill— 1 f0 I ^MI K <br />