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, <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1 of 2 <br /> DC PZ P-2017-00035 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE 41 it AGENT/CONTRACTOR NAME PHONE <br /> HUTCHINS REV TR,ALAN B&MICCA S (608)€42,--1.264-- 6 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> --204 A_1 AVC\/I CIAI A\/ <br /> /3 6-0, rnmen <br /> (City,State,Zip) �1 V R I I e.y l ( (City,State,Zip) <br /> E-MAIL ADDRES M 0" I`` I TU re L ���v(((•v���-i-E_MAIL ADDRESS <br /> C1/461 to t KS ; htts. et' 3� 70? <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0506-311-9210-0 TOWN OF PERRY 31 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 132 DRAMMEN VALLEY <br /> subject to field verification.) RD <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 13150 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RH-1 Rural Homes 3.4 Description:IN GROUND POOL AND DECK 329-Other <br /> District <br /> Category ® Residential ❑ Commercial El Agricultural SEWER SANITARY PERMIT NO. <br /> 11 Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 10312 <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES @ NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 0 798 <br /> Sq.Ft. Sq.Ft.798 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $74,070.00 <br /> 0 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $109.85 <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 pry 1 ps by Dane Co ty zoning inspectors for the <br /> purposes of determining compliance with the zo ' ;,irdia nce.. <br /> Owner&Agent hereby agree to comply with all Dane County �'r -, A' _ <br /> Ordinances.Any unauthorized change from the information or <br /> ,,%►I AP � DAT plans submitted will invalidate the permit. .,�� , I / I <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIR D? DATE ISSUED INITIALS 1st INSPECTION DATE INITIA S <br /> 41 A ES ® NO 02/21/2017 HJH3 <br /> DATE REVIEWED INITIALS Q 2nd INSPECTION DATE INITIALS <br /> Initials:: ''�� oz '. 1 / � 1 t/( <br /> fiI cX 1 <br />