Laserfiche WebLink
DANE COUNTY SHORELAND ZONING PERMIT ZONING PERMIT NO. Page 1of2 <br /> DCPSHL-2017-00058 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> HOWARD C GUST DANE COUNTY PARKS (608)224-3743 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2624 SEVEN SPRINGS RD 5201 FEN OAK DR RM 208 <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 MADISON, WI 53718 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> CLOSE.SARAH @COUNTYOFDANE.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0608-181-8500-3 TOWN OF VERONA 18 NE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2624 SEVEN SPRINGS RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL SQ FOOTAGE PROPOSED PROJECT: New Structure/Addition ; <br /> A-1 Ex Exclusive Ag Description:GUST TRACT BRIDGE REPLACEMENT OVER ; i <br /> District SUGAR RIVER(DC PARKS) z: t, I `,_ <br /> PROJECT INFORMATION App for Other.BRIDGE 4 ) <br /> SEWER r ! . 3.I <br /> Septic 1� 11� <br /> 1- X1g1 ` <br /> REZONE NO. C.0 P.NO. VARIANCE NO. 3 :EK ay <br /> DEED RESTRICTION <br /> 0 YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND C{„ q� t <br /> -` 6p d i <br /> D YES 0 NO 0 YES 0 NO 0 YES ❑ NO ii, : ' ' x £ l ' <br /> Existing Impervious Proposed Impervious '':'0,14.31'1111, --.,,,,,,1: <br /> Sq.Ft. Sq.Ft. � <br /> f !Ilifq.1, -,i3III:k;likf0::: :lifill sk <br /> Setback from Ordinary High Water Mark Water Body Name ' x tT <br /> SUGAR RIVER !T-2,:-;.::,F x l,iPERMIT 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 $IGNAT " 14 °- . <br /> Ordinances.Any unauthorized change from the information or -' - <br /> plans submitted will invalidate the permit. / ' S /L i,1/ <br /> OFFICE I!Sr 3NLY (form version 01.01.00) <br /> DATE ISSUED —Pr.IALS INSPECTION DATE INITIALS <br /> 08/11/2017 HJ H 3 <br /> DATE REVIEWED INITIALS <br />