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ZONING PERMIT NO. Page 1 of 2 <br /> DANE COUNTY ZONING PERMIT ZONING DCPZP-2017-00194 <br /> AGENT/CONTRACTOR INFORMATION <br /> OWNER INFORMATION <br /> PHONE AGENT/CONTRACTOR NAME <br /> PHONE <br /> OWNER NAME ( <br /> GARY F STUEBER (608) 575-4556 <br /> ADDRESS(Number,Street) <br /> BILLING ADDRESS(Number,Street) <br /> 2651 GASTON RD • <br /> (City,State,Zip) <br /> • <br /> (City,State,Zip) <br /> COTTAGE GROVE, WI 53527 <br /> E-MAIL ADDRESS <br /> E-MAIL ADDRESS <br /> s2bcar1vet @aol.com <br /> PARCEL NO. 1/a 1/4 1/4 5 NE <br /> TOWNSHIP SECTION SE <br /> S <br /> PROPERTY ADDRESS <br /> 0711-051-9520-5 TOWN OF COTTAGE GROVE TYPE <br /> HOUSE NO. ST.DIRECTION STREET NAME GASTON PE RD <br /> (Assignment of new address Is 2651 <br /> subject to field verification.) <br /> LOT <br /> BLOCK I C.S.M.NO.or PLAT NAME CSM 02980 <br /> 1 CENSUS CODE <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition 329_Other <br /> RH-1 Rural Homes 2.65 Description:13' 0'storage building <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. 0 YES ® NO <br /> C-Town Road 2055 <br /> SHORELAND FLOOD ZONE <br /> WETLAND EC/SW NO <br /> ❑ YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> 1st FLOOR TOTAL SQUARE FEET <br /> HEIGHT(In Feet) BASEMENT 260 <br /> 9 Sq.Ft. Sq.Ft.260 <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR <br /> 3rd FLOOR $1,500.00 <br /> PERMIT FEE <br /> 1 sq.Ft. Sq.Ft. $69.50 <br /> am the owner of the property or an authorized agent acting on behalf of the owner of <br /> I, theundersigned, <br /> the property. I certify that the work to be performed, as part of this <br /> able zoning ordinances. I understand that failure <br /> noted on the submitted plans and comply with the app ' 9 <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 <br /> open concerning <br /> water construction <br /> near or on wetlands, lakes, and,streams. Wetlands that are not associated be <br /> difficult to identify. Failure tomply may result in removal or modification of construction that violates <br /> the law or other penalties or costs. rot more irlvform4tion, visit the Department of N cte ural Resources web <br /> page at www.dnr.state.wi.us or contact the Department of Natural <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 /> SIGNA E: t a DA E: t <br /> Owner&Agent hereby agree to comply with all Dane County 9 ,�/ / ✓/ ' <br /> Ordinances.Any unauthorized change from the information or . i <br /> plans submitted will invalidate the permit. -'��L form version 03.01.01)tr- <br /> OFFICE USE ONLY <br /> DATE ISSUED INITIALS <br /> � 1st INSPECTION DATE INITIALS <br /> SURVEY REQUIRED 7 04/21/2017 SSA1 INITIALS <br /> ❑ ® <br /> YES NO DATE REVIEWED INITIALS 2nd INSPECTION DATE <br /> Initials:_ <br />