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DANE COUNTY ZONING PERMIT DCPZP PERMIT 062 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> WAHLIN LIVING TR,WILLIAM D&RENEE L (608) 225-5402 Shaw Building&Design Inc. (608) 877-1131 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2763 ESQUIRE LN 3185 Deer Point Drive <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 Stoughton, WI 53711 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> chris @shawbuilders.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0612-304-8695-0 TOWN OF CHRISTIANA 30 SE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 1926 County Highway W <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 14534 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-2 (2) Agriculture 3.57611094 Description:sfr w/covered porch&deck 101 -SFR (detached) <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> 11 otner: Private 13201700273 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO VARIANCE NO. DEED RESTRICTION <br /> B-County Highway 11094 ❑ 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 /> 7115 <br /> 21 Sq.Ft.2750 Sq.Ft.4365 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $900,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $583.63 <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 County zoning inspectors for the <br /> purposes of determining compliance with the zoning ordinance <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATUR . Ow r/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans n <br /> plans submitted will invalidate the permit. oik / k;\ #'4a_. 7 <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 09/12/2017 SCW1 <br /> i ❑ Yity ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initialsl <br />