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DANE COUNTY ZONING PERMIT DCPZP 2017 00395 Page 1 of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JENNA LEA VEDVIG (608) 778-5456 <br /> BILLING ADDRESS(Number, ADDRESS(Number,Street) <br /> a6 CO Tovi0 )-10,1 <br /> (City,State,Zip) M+. 14 0 r.eo k j�° 1d (City,State,Zip) <br /> i i T RACK °'R-22O5- ' 1 v\, -1� llw <br /> E-MAIL ADDRESS r■1 "Ta E-MAIL ADDRESS <br /> jennarunde @gmail.com ■ <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0607-171-9080-0 TOWN OF SPRINGDALE 17 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2600 TOWN HALL RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 10448 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture 15.36 Description:chicken coop 329-Other <br /> District <br /> Category ❑ Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ® Other:chicken coop Private no fixtures <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> ❑ YES ® NO <br /> SHORE ND FLOOD ZONE WETLAND EC/SW NO. <br /> ��ip <br /> �� <br /> YES (0. 10 ❑ YES RI NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 134 <br /> 12 Sq.Ft. Sq.Ft. 134 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $2,500.00 . <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $15.00 <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 ■ww.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 SI • • RE: Owner/: . -nt DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. /�i/ . , ,' <br /> OFFICE'USE/ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/30/2017 SCW 1 <br /> DIES ® NO DATE REVIEWED INITIALS��� 2nd INSPECTION DATE INITIALS <br /> Initials: V ? ?'. 1 7 1,J RK <br />