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DANE COUNTY ZONING PERMIT DCPZP 2017-00103 Page 1 oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE Co <br /> PETERHNSOR R St.7) (608) 225-2603 JOSH WANTA (608) 279- <br /> BIL`IN,G(�DDREaS(Number� treat) � ly ^I <br /> ADDRESS(Number,Street) ^S�(l 3/�o, o, Ck C� 7602 RIVERSIDE-03— Q (_'`/1riJJ! <br /> (Ci Stat Zip)' (City,State,Zip) <br /> :- i C� `j V 41,.. t V� Z sS-' f I VERONA, WI 53593 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> peter @silvertrodl.com josh @Iegacycr.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0710-352-6914-3 TOWN OF BLOOMING GROVE 35 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3594 RANKIN RD <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 144 APRIL HILL-1 ST ADDITION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-2 Residence .3 Description:new house and cover porch 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2017-00059 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 1169 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> fl YES @ NO ❑ YES 0 NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 5714 <br /> 18 Sq.Ft.2358 Sq.Ft.3356 <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $325,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $478.55 <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 SIGNATU-E 0 e /A e DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. V 3-2/-/7 <br /> OFFICE USE OI,!LY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 03/21/2017 SSA1 <br /> ® YES ❑ DATE REVI <br /> NO <br /> `�` E ED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: v 1l ^1- 17 P ri K <br />