Laserfiche WebLink
DANE COUNTY SHORELAND ZONING PERMIT ZONING PERMIT 0. Page 1 of2 <br /> DCPSHL-2017-00047 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> NICOLE M CARDAMONE (312)401-3444 MARTEN BUILDING (608)212-6934 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 931 HARPER DR PO BOX 64 <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> NICOLEM.CARDAMONE @GMAIL.COM RANDY @MARTENBUILDING.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0610-092-7261-0 TOWN OF DUNN <br /> 9 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2806 WILLOW CT <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 12377 <br /> ZONING DISTRICT PARCEL SQ FOOTAGE PROPOSED PROJECT: New Structure/Addition <br /> R-3 Residence 7285 Description:SFR <br /> District <br /> PROJECT INFORMATION APP for a Residential Structure; SEWER <br /> Sewer <br /> REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND y.. : <br /> YES 0 NO 0 YES ® NO YES ® NO <br /> Existing Impervious Proposed Impervious <br /> Sq.Ft.0 Sq.Ft.2789 <br /> Setback from Ordinary High Water Mark Water Body Name , <br /> 260 LAKE WAUBESA PERMIT FEE <br /> $150.00 <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 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 SIG - : • •t <br /> Ordinances.Any unauthorized change from the information or ` <br /> plans submitted will invalidate the permit. ` I. : 7— ,7/ —/7 <br /> OFFICE USE ONLY (form version 01.01.00) <br /> DATE ISSUED INITIALS INSPECTION DATE INITIALS <br /> 06/30/2017 HJH3 <br /> DATE REVIEWED INITIALS <br />