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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1of2 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE RUSSELL W BALLWEG (608) 643-8235 Jason Kirch (608) 393-6434 BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) 6556 COUNTY HIGHWAY KP 7225 Linsley Ln. (City,State,Zip) (City,State,Zip) MAZOMANIE, WI 53560 Sauk City, Wi 53583 E-MAIL ADDRESS E-MAIL ADDRESS PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 0907-343-8675-0 TOWN OF ROXBURY 34 SW NW PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is 6498 County Highway KP subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 2 CSM 14328 ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE RH-2 Rural Homes Description:Single family residence 101 -SFR (detached) District Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. ❑ Other Private 2017-41 ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION B-County Highway ❑ YES ® NO SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO EC2016-0256 HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 28.6 Sq.Ft.2081 Sq.Ft.3367 5448 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $360,000.00 1 Sq.Ft. Sq.Ft. PERMIT FEE $458.60 I, the undersigned, am the owner of the property or an authorized agent acting on behalf of the owner of the property. I certify that the work to be performed, as part of this zoning permit, will be constructed as noted on the submitted plans and comply with the applicable zoning ordinances. I understand that failure to comply with any provision or condition of this permit renders this zoning permit null and void and subject to enforcement action. I acknowledge that I am responsible for complying with State and Federal laws concerning construction near or on wetlands, lakes, and streams. Wetlands that are not associated with open water can be difficult to identify. Failure to comply may result in removal or modification of construction that violates the law or other penalties or costs. For more information, visit the Department of Natural Resources web page at www.dnr.state.wi.us or contact the Department of Natural Resources Service Center. I hereby consent to the entry on the permitted premises by Dane County zoning inspectors for the purposes of determining compliance with the zoning ordinances. Owner&Agent hereby agree to comply with all Dane County .N' URE: Owner/Agent 1 'TE: Ordinances.Any unauthorized change from the information or ' plans submitted will invalidate the permit. A ' - 7 OFFICE...)SE ONLY (form version 03.01.`00) SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS 03/29/2017 DJ E 1 ' ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: