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DANE COUNTY ZONING PERMIT DCPZP201700379 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME HONE <br /> BRUCE M SAYLES (608) 279-7291 Cleary Building Corp. �(o N?)3?4 - © . <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4212 SPRECHER RD 190 Paoli St. <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53718 \I6- & n o , W ,.i s -3 5 9 <br /> E-MAIL ADDRESS E-MAIL DDRESS <br /> -I- leescf o.J deaf- �U'I Ic ;I,I .COrn <br /> PARCEL NO. TOWNSHIP SECTION 1/4 4 1/4 <br /> 0710-141-0331-0 TOWN OF BLOOMING GROVE 14 NE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4212 SPRECHER RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 11282 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-3 Residence 0.66 Description:Detached garage 438- Garage <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: <br /> Public <br /> ROAD CLASSIFICATION . <br /> REZONE NO.(� ' r, C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road Y 0� YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES ® NO 0 YES 0 NO ❑ YES 0 N <br /> HEIGHT(In Feet) BASEMENT •7LOOR 'TOTAL SQUARE FEET <br /> 864 <br /> 11.98 Sq.Ft. Sq.Ft.864 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $28,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $114.80 <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 SIGN' "fi' • %" ner/Agent DATE. <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. - (�C((7 <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/26/2017 DJ E 1 <br /> //�/j YES ❑ NO DATE REVIEWED j INITIALS �^ 2nd INSPECTION DATE INITIALS <br /> Initials:_1Y`-` 7, ? - / fi P ,_1I2 <br />