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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ROBERT W MARTY (608)215-8113 Hensen Builders Inc. (608) 849-4736 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2861 ERBE RD - 110 Baker St., Ste. B <br /> (City,State,Zip) (City,State,Zip) <br /> BLUE MOUNDS, WI 53517 Waunakee, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> hensenbuilders@tds.net <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0606-091-9440-0 TOWN OF BLUE MOUNDS 9 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2861 ERBE RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 3 CSM 10913 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Alteration to existing building CENSUS CODE <br /> RH-2 Rural Homes 4.217 Description:3 season porch over existing deck 434- Residential Addition <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Othe Private <br /> r. <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 8203 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES IO NO ❑ YES m NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 144 <br /> —45—pZ. © Sq.Ft Sq.Ft 144 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $37,363.00 <br /> 1 Sq.Ft Sq.Ft PERMIT FEE <br /> $60.80 <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 /> Owner&Agent hereby agree to comply with all Dane County SIGN RE: Owner/Agent D TE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. ..;I ` <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED 7 DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 02/16/2017 SCW1 <br /> • • YES ® NO <br /> DATE REVIEWD INITIALS 2nd INSPECTION DATE INITIALS <br /> 1 l(0 -1 r If' <br />