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ZONING PERMIT NO. Page 1 of 2 <br /> DANE COUNTY ZONING PERMIT ZONING DCPZP-2017-00145 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE <br /> AGENT/CONTRACTOR NAME PHONE <br /> CASSANDRA M VANDERWALL (608) 318-0819 <br /> ADDRESS(Number,Street) <br /> BILLING ADDRESS(Number,Street) <br /> 6762 PEACEFUL CT <br /> (City,State,Zip) <br /> (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS <br /> E-MAIL ADDRESS <br /> cassie.vanderwall @gmail.com <br /> PARCEL NO. 1/4 1/a <br /> 29 NE <br /> TOWNSHIP SECTION 1/4 NW <br /> 0911-291-3067-3 TOWN OF BRISTOL <br /> PROPERTY ADDRESS <br /> ST.TYPE <br /> HOUSE NO. ST.DIRECTION STREET NAME CT <br /> (Assignment of new address is 6762 PEACEFUL <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME 57 PRAIRIE VIEW HEIGHTS-2ND ADDITION <br /> CENSUS CODE <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition 329_Other <br /> R-1 Residence 0.51 Description:chicken coop <br /> District SANITARY PERMIT NO. <br /> Agricultural SEWER <br /> Category ® Residential ❑ Commercial ❑ g Private <br /> ❑ Other: <br /> C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> ROAD CLASSIFICATION REZONE NO. <br /> E All Other 1697 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE <br /> WETLAND EC/SW NO <br /> ❑ <br /> YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> TOTAL SQUARE FEET <br /> HEIGHT(In Feet) <br /> BASEMENT 1st FLOOR 100 <br /> 12 Sq.Ft. Sq.Ft.100 <br /> PROJECT COST <br /> $57.50 <br /> 2nd FLOOR 3rd FLOOR <br /> NO.OF STORIES PERMIT FEE <br /> 1 sq.Ft. Sq.Ft. $15.00 <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 able of this zoning o i permit will/ill understand constructed <br /> that d as <br /> noted on the submitted plans and comply with the applicable zoning <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 Federal l with open water can ruction <br /> near or on wetlands, lakes, and streams. Wetlands that are not associated <br /> difficult to identify. Failure to comply may result in removal i t modification of construction <br /> of Natural Resourlcestweb <br /> the law or other penalties or costs. For more information, vs <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 SIGNATURE: OwnerlAgent <br /> DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. (form version 03.01.01) <br /> OFFICE USE ONLY <br /> DATE ISSUED INITIALS <br /> 1st INSPECTION DATE INITIALS <br /> yRVEY REQUIRED? 04/04/2017 SSA1 INITIALS <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE <br />