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DCPSHL-2017-00067
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DCPSHL-2017-00067
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9/12/2017 1:41:11 PM
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DCPSHL-2017-00067
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DANE COUNTY SHORELAND ZONING PERMIT ZONING PERMI1T NO.0 Page 1 of 2 <br /> DCPSHL-207-0067 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> CHARLES TERRY WEDEKIND (608) 838-7452 CHAMPION (262) 527-1207 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2533 YAHARA DR 1312 FLEET FOOT DRIVE <br /> (City,State,Zip) (City,State,Zip) <br /> MCFARLAND, WI 53558 WAUKESHA, WI 53186 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> SIMES @GETCHAMPION.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0610-142-7700-5 TOWN OF DUNN 14 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2533 YAHARA DR <br /> subject to field verification.) <br /> LOT BLOCK (C.S.M.NO.or PLAT NAME <br /> 10 YAHARA PARK <br /> ZONING DISTRICT PARCEL SQ FOOTAGE PROPOSED PROJECT: Alteration to existing building <br /> R-3 Residence 20299 Description:12'X 14'SUNROOM ADDITION OVER AN EXISTING ' '. <br /> District DECK .s k - <br /> PROJECT INFORMATION <br /> App for a Vertical Expansion; SEWER <br /> Septic <br /> REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION : .. <br /> ❑ YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND c = <br /> ® YES 0 NO 0 YES 0 NO E YES ® NO g ' ,« A, Al <br /> Existing Impervious Proposed Impervious Wi ,- ` " f <br /> Sq.Ft. Sq.Ft. 168 <br /> -"s b i$ 9 Y, k. -. n3Y. gn p <br /> Setback from Ordinary High Water Mark Water Body Name ' <br /> 56.3' YAHARA RIVER 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 <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 w ■w.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 SIGNATURE: •wner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. gr . ".------___ C_g._i <br /> OFFICE USE ONLY (form version 01.01.00) <br /> DATE ISSUED INITIALS INSPECTION DATE INITIALS <br /> 09/07/2017 PMK2 <br /> DATE REVIEWED INITIALS <br />
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