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DANE COUNTY ZONING PERMIT DCPZP-2016-00692 Page 1of2 <br /> OWNER INFORMATION AGENTICONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MCGRATH REV TR,PATRICK R&KELLY A (608)692-4716 Keuler Construction Inc. (608)798-1771 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2087 FRAWLEY DR 8308 State Road 19 <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE,WI 53590 Cross Plains, WI 53528 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> kell.mcgrath4&gmail.com keulerconstruction @hotmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 114 114 <br /> 0808-312-2112-0 TOWN OF SPRINGFIELD 31 NW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7893 Autumn Pond TRAIL <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 22 AUTUMN POND <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1A Residence 1.506 Description:sfr wI porches 101 -SFR(detached) <br /> District <br /> Category 0 Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13201600322 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 9638 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ® NO ❑ YES ® NO ❑ YES ® NO contact re driveway <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 7176 <br /> 22 Sq.Ft. 1879 Sq.Ft.3517 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $644,000.00 <br /> 2 Sq.Ft. 1780 Sq.Ft. PERMIT FEE <br /> $588.20 <br /> 1, 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 Cour,y SIGNATURE: Ow '•r/Ag nt DATE: <br /> Ordinances.Any unauthorized change from the information or Ar0.,440 , t t �� �r <br /> plans submitted will invalidate the permit. 440 , 0 • t �•1 - ( <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st PECTION DATE INITIALS <br /> 10/19/2016 SCW 1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />