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DANECOUNTY ZONING PERMIT ZONING PERMIT NO Par�clof2 <br /> DCPZP-2016-00730 <br /> OWNER INFORMATION 1 AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> GRAY REAL ESTATE LLC (608)437-2320 Sign Art Studio (608)437-2320 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 221 W TOWN ST 126 South First Street <br /> (City,Stale,Zip) (City,State,Zip) <br /> PORTAGE,WI 53901 Mt Horeb,WI 53572 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> kirk @signartmadison.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1M <br /> 0710-051-3365-8 TOWN OF BLOOMING GROVE 5 NE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address le 3321 COMMERCIAL AVE <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 52 GALLAGHER,ELISHA L 2ND ADD REPLAT OF BLKS 11,12,13,15,16&PT BLK 14 <br /> TONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: CENSUS CODE <br /> C-2 Commercial 0.1239 Description;15'x 10'x 33'pylon sign,15.5'x 5'x 14'east elevation 329-Other <br /> District wall sign <br /> Category ❑ Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> p Other: Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> A-US or Slate Highway DCPREZ-1979-02304 <br /> ❑ YES 0 NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES 0 NO ❑ YES ® NO ❑ YES la NO <br /> HEIGHT(In Feel) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 33 Sq.Ft. Sq.Ft.227 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR #Error <br /> 1 Sq FI Sq Ft PERMIT FEE <br /> $0.00 <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 concerni - ••nstruction <br /> near or on wetlands, lakes, and streams.Wetlands that are not associated with open w , n be difficult <br /> to identify. Failure to comply may result in removal or modification of construction tha -s the law or <br /> other penalties or costs. For more information, visit the Department of Natural Reso ,,.e, eb page at <br /> www.dnr.state.wi.us or contact the Department of Natural Resources Service Cen ..I`. <br /> I hereby consent to the entry on the permitted premises by Dane County zonin oitli ctors for the <br /> purposes of determining compliance with the zoning ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County SIGN"TIJ'E. +r er/Agent rt DATE: <br /> Ordinances.Any unauthorised change from the information or r t <br /> plans submitted will Invalidate the permit. `J A <br /> OFFICE USE CNLY (form version 03,01,00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> YES ® NO <br /> 0 11/03/2016 RLB <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Inaud: 441 <br /> it din <br />