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DANE COUNTY ZONING PERMIT DCPZP 2017 00148 Page 1 oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JOSEPH HANSEN (414) 870-2374 TIM DYER (608)444-3749 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1651 KESTREL LN 1130if�E-A#B.B�t 1 r Ia nig' U I , <br /> (City,State,Zip) (City,State,Zip) <br /> BLUE MOUNDS, WI 53517 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> hansenj77 @gmail.com timdyer1@gmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0506-062-8540-5 TOWN OF PERRY <br /> 6 NW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 1705 KESTREL LN <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 05431 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RH-2 Rural Homes 2.90 Description:solar panels 329 -Other <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: <br /> Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 3778 0 YES ® NO <br /> SHORE ND FLOOD ZONE WETLAND EC/SW NO. <br /> OYES ViS(_NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 750 <br /> 9 Sq.Ft. Sq.Ft. <br /> PROJECT COST <br /> NO,OF STORIES 2nd FLOOR 3rd FLOOR $35,000.00 <br /> 0 Sq.Ft. Sq.Ft. PERMIT FEE$.1. 5 S O,O O <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 SIGNAT -E: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or /� J(/ <br /> plans submitted will invalidate the permit. - ' `Z I £ '%)/' <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/05/2017 SSA1 <br /> ❑ YES ® NO DATE'REVIIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: —717) Y C 1 7 c M K <br />