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DANE COUNTY ZONING PERMIT DCPZP 2017 00115 Pagel of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> FRANK J GOBEL (608) 636-5130 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7324 E CATES RD <br /> (City,State,Zip) (City,State,Zip) <br /> BELLEVILLE, WI 53508 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> gobsgto @aol.corn <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0508-212-9770-0 TOWN OF MONTROSE 21 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7324 E CATES RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 12798 <br /> ZONING DISTRICT 'PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-2 (2)Agriculture • 2.0 Description:in ground pool 329-Other <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road 10068 ❑ 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 /> 594 <br /> 0 Sq.Ft. Sq.Ft. . <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $24,000.00 <br /> 0 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $94.55 <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 penaltipp,r costs. For more information, visit the Department of Natural Resources web <br /> page at www.dn t . Iis,�rcontad he 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 complice with the zoning ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATURE: O�Rffl6Fh DAT : <br /> Ordinances.Any unauthorized change from the information or C <br /> plans submitiefiNVJ,invalidate the permit. ._ __ LA 1 , <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED 7 DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 03/27/2017 SSA1 <br /> ❑ YES ® NO DATE R VIEWED INITIALS^ 2nd INSPECTION DATE INITIALS <br /> 7 Initials: - 10 - / P ',AK <br /> 111 <br />