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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1of2 <br /> DCPZP-2017-00416 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ROBERT A TROIA (608) 516-9005 Recreational Concepts Inc. (608) 835-2780 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4448 CELESTIAL CIR 121 N Main St., <br /> (City,State,Zip) (City,State,Zip) <br /> CROSS PLAINS, WI 53528 Oregon, WI 53575 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> cynthiatroiabeth @gmail.com recconinc @ymail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0707-102-8801-4 TOWN OF CROSS PLAINS 10 NW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4448 CELESTIAL CIR <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 4 CSM 09288 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition <br /> RH-3 Rural Homes 15.64 Description:deck&above ground pool CENSUS CODE <br /> District 329-Other <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> ❑ YES RI 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 /> Sq.Ft. <br /> Sq.Ft.828 828 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $5,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $112.10 <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 subject <br /> 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 difficult <br /> to identify. Failure to comply may result in removal or modification of construction that violates the law or <br /> other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> 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 S - RE o ner/Agen DATE: <br /> Ordinances.Any unauthorized change from the information o, <br /> plans submitted will invalidate the permit. I 7/(i / <br /> .ski _______ <br /> OFFICE IJSE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INI+I, . V 1st INSPECTION DATE INITIALS <br /> ❑ YES ® NO 07/10/2017 SCW1 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />