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DANE COUNTY ZONING PERMIT DCPZP 2017 00337 Pagel oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> BRIAN L LODAHL (608) 556-5023 SeKAAA73 C Lo1d fJi, Z37-(23/2 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3510 KITTLESON CT 526 L_owtwte✓c:c,/ Avz <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 q <br /> K -P✓27c1✓;C( W= j352D <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> blodah169@yahoo.com <br /> 40L. Zi anNnavw.av-Q -ea+tii KIS aN,Q/Weld t.Cow. <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0810-021-4266-0 TOWN OF BURKE 2 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3510 KITTLESON CT <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 7 CHARLOTTES WALK <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture .697 Description:deck and pool 329-Other <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> El otner: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> D 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 /> 477 <br /> 0 Sq.Ft. Sq.Ft. <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $15,000.00 <br /> 0 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $85.78 <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 b, ma- - C oni inspectors for the <br /> purposes of determining compliance with the zoning ors' :n; s. <br /> Owner&Agent hereby agree to comply with all Dane County SINAT - i , ,er/Age , I ll E: <br /> Ordinances.Any unauthorized change from the information or �/ 3� <br /> plans submitted will invalidate the permit. <br /> OFFICE USE ONL`. (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/12/2017 SSA1 <br /> 0 ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: , 2._ <br />