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DANE COUNTY ZONING PERMIT DCPZP 2016 00669 Page of <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JOSHUA WILLS (608) 501-8632 JOHN MCDONOUGH (608) 501-8632 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 210 GLENWAY ROAD 210 GLENWAY ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> BROOKLYN, WI 53521 BROOKLYN, WI 53521 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> DUCK.MCDONOUGH @ICLOUD.COM DUCK.MCDONOUGH @ICLOUD.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0509-152-9850-0 TOWN OF OREGON 15 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 985 GLENWAY RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 13497 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RH-2 Rural Homes 4.5 Description:SFR WITH FRONT PORCH AND DECK 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2016-00311 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 10516 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES 0 NO ❑ YES IZ) NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 7344 <br /> 14 Sq.Ft.2525 Sq.Ft.4819 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $272,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMFT FEE <br /> $600.80 <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 /> � , <br /> Owner&Agent hereby agree to comply with all Dane County SIGNAT 77rM'er/'g: Vir, DATE: <br /> Ordinances.Any unauthorized change from the information or , , <br /> plans submitted will invalidate the permit. � .,4. _1 rQ-/oZ` i6 <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY RE' IRED? DATE ISSUED INI1rIALS 1st I -PECTIO, 'ATE INITIALS <br /> 10/12/2016 PMK2 <br /> ■1 YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials:/ <br /> / <br />