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DANE COUNTY ZONING PERMIT DCPZP20170NO. Page1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MATTHEW M OLIVER MATSON CUSTOM HOMES, INC. (608) 873-0500 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2225 STONE CREST RD 1601 E MAIN ST <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 STOUGHTON, WI 53589 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> TMATSON @MATSONHOMES.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0510-134-8320-0 TOWN OF RUTLAND 13 SE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3211 COUNTY HIGHWAY A <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 2 CSM 14503 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-2 (1)Agriculture 1.25 Description:SFR 101 -SFR (detached) <br /> District <br /> Category 0 Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2017-0016 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B-County Highway 11037 <br /> ❑ 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 /> 4330 <br /> 22.5 Sq.Ft. 1360 Sq.Ft.2346 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $290,000.00 <br /> 2 Sq.Ft.624 Sq.Ft. PERMIT FEE <br /> $374.75 <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 Count zoning inspectors for the <br /> purposes of determining compliance with the zoning or... . -s. <br /> Owner&Agent hereby agree to comply with all Dane County 'AT b." -; ner/Agent TE: <br /> Ordinances.Any unauthorized change from the information or `♦ c7 72/,? <br /> plans submitted will invalidate the permit. <br /> OFFICE USE ONLY (form versio.1 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 07/27/2017 HJ H 3 <br /> ❑ YES ® NO DATE REVIEWED INITIALS <br /> J� 2nd INSPECTION DATE INITIALS <br /> nitials: ? -04- 17 ` ' \ <br />