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DANE COUNTY ZONING PERMIT DCPZP-2017-00680 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> NOVATION SENIOR APARTMENTS LLC (262)842-0452 CONSTRUCTION MANAGEMENT (312)613-6180 <br /> ACCnr IATFC inir, <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 4011 80TH ST 4015 80TH STSUITE F <br /> (City,State,Zip) (City,State,Zip) <br /> KENOSHA, WI 53142 KENOSHA, WI 53142 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ADAM @BEARDEVELOPMENT.COM ERIC.MITCHELL @CMAOFWI.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0709-363-2345-0 TOWN OF MADISON 36 SW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2675 NOVATION PKWY <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 13543 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> PUD Planned Unit 1.57 Description:PUD SENIOR APARTMENT BUILDING 4 STORY 105- Multi-family (5+ Units) <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other Public 17-0011 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other 11015 ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 0 YES ® NO ❑ YES ® NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 77501 <br /> 50 FEET Sq.Ft. 15684 Sq.Ft. 15420 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $6,554,006.00 <br /> 4 or More Sq.Ft.15530 Sq.Ft. 15530 PERMIT FEE <br /> $5863.00 <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 SIGNATURE: Owner/Agent DATE' <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. C444C- 10-12-17 <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 10/11/2017 SLJ3 <br /> ® YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials; f 10/11/C7 5 (. <br />