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DANE COUNTY ZONING PERMIT DCPZP 2017 00604 Page1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> THOMAS L PORTER (608) 301-7459 ED SELTZNER (608) 279-7088 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3136 HAPPY VALLEY RD 7370 WILBURN ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ESELTZNER @GMAIL.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0911-181-8210-0 TOWN OF BRISTOL <br /> 18 NE NE <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7344 NORWAY RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 14419 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition 'CENSUS CODE <br /> A-1 Agriculture 1.2 Description:SFR 101 - SFR (detached) <br /> District <br /> Category 0 Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO <br /> Private 13-2017-00237 <br /> ❑ <br /> Other <br /> - <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <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 /> 4919 <br /> 28 Sq.Ft.2055 Sq.Ft 2864 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $280,000.00 <br /> 1 Sq.Ft Sq.Ft PERMIT FEE <br /> $418.93 <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 ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATUR : • ner/A•ent DATE: <br /> Ordinances.Any unauthorized change from the information or , <br /> plans submitted will invalidate the permit. VI/ 7 <br /> ice./ <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 09/11/2017 P M K2 <br /> ❑ YES ® NO DATE REVIEWED INITIALS L 2nd INSPECTION DATE INITIALS <br /> Initials: F “13/(7 <br />