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DANE COUNTY ZONING PERMIT DCPZP-2017-00052 Page 1of2 <br /> OWNER INFORMATION j AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MREC VH MADISON LLC (608)226-3100 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 6801 SOUTH TOWNE DR <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON,WI 53713 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-203-4097-0 TOWN OF MIDDLETON 20 SW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of newaddressis 7622 ENGLISH DAISY CT <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 77 SPRUCE HOLLOW <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture .89 Description:SFR 101 -SFR(detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2017-00026 <br /> ❑ Other. <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other ❑ 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 /> 5284 <br /> 23.75 sq.Ft.1516 Sq.Ft.2428 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $486,789.00 <br /> 2 Sq.Ft.1340 Sq.Ft PERMIT FEE <br /> $446.30 <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 subject <br /> 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 difficult <br /> to identify. Failure to comply may result in removal or modification of construction that violates the law or <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> 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 SIG,AT "E: • ner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or `'� <br /> plans submitted will invalidate the permit. '�7.. --f <br /> OFFICE USE ONLY (form version 03.01.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INS 0 TE INIT • <br /> 02/28/2017 HJH3 <br /> YES ❑ NO DATE REVIEWED INITIALS 2nd IN lOgN D - G INITIALS <br /> Initials: <br /> N <br />