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DANE COUNTY ZONING PERMIT DCPZP 2017 00238 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> G & N LAND HOLDINGS LLC (608) 509-8904 GARY DVORAK (608) 509-8904 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1471 US HIGHWAY 51 1471 f3-• U.,j /-1, 1,-% , <br /> (City,State,Zip) (City,State,Zip) I <br /> STOUGHTON, WI 53589 STOUGHTON, WI 53589 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> info @stoughtongardenercenter.com info @stoughtongardenercenter.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0510-011-9801-9 TOWN OF RUTLAND 1 NE SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 1457 OAK OPENING DR <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 1 CSM 08144 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> C-2 Commercial 11.8 Description:c.n.r storage-building K 324-Offices <br /> District 15C/SO <br /> Category 0 Residential ® Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> p Other: Public <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road ^� <br /> t CSC) ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> O YES ® NO 0 YES ® NO ll YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 4500 <br /> 12 Sq.Ft. Sq.Ft.4500 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $80,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $360.00 <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 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 SIGNA URE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. A' - <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQU 'ED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 05/05/2017 SSA1 <br /> 74 YES NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 5 r ^I ? P ri .< <br />