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SITE PLAN APPROVAL FORM <br /> NAME: Roy and Kia Lassen <br /> ADDRESS: 9962 County Rd Y <br /> PARCEL NUMBER: 034/0906-233-8880-9 <br /> ZONING: RH-1 DCPREZ-0000-04440 <br /> ACRES: 2.052 <br /> SITE PLAN APPROVAL: `'/ <br /> By Land Plan Commission: i (,6/ Z� Date: February 6. 2017 <br /> Rick Wipperfurt , rman <br /> (-9-By Town Board: ° Date: February 13,2017 <br /> Fred Wolf, Chairman,, <br /> Conditions: <br /> Site plan for porch addition to existing structure attached <br /> The applicant will receive two copies of this form.The form must be completed prior to application for a <br /> county zoning permit and submitted both to Dane County Zoning and to the Town of Mazomanie <br /> Building Inspector when applying for building permit. <br /> Dane County Zoning: (608) 266-9083 www.countyofdane.com/plandev/zoning <br /> Tracy Johnson, Building Inspector: (608)444-0372 <br /> Town of Mazomanie Phone: (608) 795-2920 <br /> 711 W Hudson St E-mail: twnmazo @gmail.com <br /> Mazomanie,WI 53560 Website:townofmazomanie.org <br />