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DANE COUNTY ZONING PERMIT DCPZP201700728 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> BRIAN MILLER (608) 849-6770 PREMIER BUILDERS INC (608) 849-6770 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 500 106 AVE NE UNIT#703 102 N HOLIDAY DRIVE <br /> (City,State,Zip). (City,State,Zip) <br /> BELLEVUE, WA 98004 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> MILLER_BRIAN_P @MSN.COM JEANETTE.ACKER @GMAIL.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-321-4222-0 TOWN OF MIDDLETON 32 NE SW <br /> PROPERTY ADDRESS HOUSE NO ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7491 LOVELAND PASS <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO or PLAT NAME <br /> 12 ASPEN MEADOW ESTATES <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Agriculture 0.768 Description:SINGLE FAMILY RESIDENCE 101 -SFR (detached) <br /> District <br /> Category ® Residential 0 Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2017-00364 <br /> Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO VARIANCE NO. DEED RESTRICTION <br /> E-All Other <br /> 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 /> 6639 <br /> 16 ' MEAN Sq.Ft.2573 Sq.Ft.4066 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $490,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $547.93 <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 SIGNATURE: 0 ner/ gen DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIA =4°F- 1st INSPECTION DATE INITIALS <br /> ® g NO 10/27/2017 SLJ3 <br /> DATE REVIEWED INITIALS r^� 2nd INSPECTION DATE INITIALS <br /> Initials: 10( 1 <br />