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DANE COUNTY ZONING PERMIT DCP7_P-2017-00139 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> EUGENE H HAHN JR Voyager Builders <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> W1175 VAUGHN RD 1500 W Main Street <br /> (City,State,Zip) (City,State,Zip) <br /> CAMBRIA,WI 53923 SUN PRAIRIE,Wisconsin 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 114 1/4 1/4 <br /> 0810-033-9173-8 TOWN OF BURKE 3 SW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 6081 PORTAGE RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 3 CSM 08129 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RH-2 Rural Homes Description: 101 -SFR(detached) <br /> District <br /> Category 0 Residential ❑ Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> Other Private 13-2017-00074 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 11098 <br /> ❑ YES 0 NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES 0 NO ❑ YES )a NO ❑ YES 0 NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 18 Sq.FL 1853 Sq.Ft.2789 <br /> 4642 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $360,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $398.15 <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 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 County 1 :o- s,' y ;d i t .r- ''' <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. ,: ti _ /,, ,O 1/— 3 <br /> OFFICE USE ONLY (farm version 03 01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> YES ® NO 04/0312017 RWL1 <br /> ❑ DATE REV WED INITIALS �� 2nd INSPECTION DATE INITIALS <br /> .. .,� Ktc1 l '/ /7 iksH <br />