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DANE COUNTY ZONING PERMIT DCPZP 2017 00189 Page1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> AARON BECKER (608) 210-2500 JM Frederick Custom Homes&Properties (608) 843-2789 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> N8594 HAY HOLLOW RD 1283 County Road D <br /> (City,State,Zip) (City,State,Zip) <br /> BLANCHARDVILLE, WI 53516 Oregon, WI 53575 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> aaron @beckeragencyllc.com freddy.jmfcustomhomes @gmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0807-182-9501-0 TOWN OF BERRY <br /> 18 NW SE <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 9338 Spring Valley RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT New Structure/Addition CENSUS CODE <br /> R-1A Residence 1.5 Description:sfr w/decks and porches 101 - SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO <br /> Private 13201600250 <br /> ❑ Other <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO VARIANCE NO DEED RESTRICTION <br /> C-Town Road 8830 <br /> YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ® NO ❑ YES 0 NO ❑ YES © NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 6752 <br /> 19 Sq Ft.2520 Sq.Ft.4232 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $580,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $1112.80 <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 SIGNATURE: Owner/ DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 04/20/2017 SC W 1 <br /> �❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />