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DANE COUNTY SHORELAND ZONING PERMIT ZONING PERMIT N0. Page 1 of 2 <br /> DCPSHL-2017-00064 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MICHAEL P SHANLEY (309) 258-7590 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 437 N MCCLURG CT <br /> (City,State,Zip) (City,State,Zip) <br /> CHICAGO, IL 60611 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> MSHANLEY @RSAC.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0611-191-6112-8 TOWN OF PLEASANT SPRINGS 19 NE SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2365 WI LLIAMS POINT DR <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 62 WILLIAM'S POINT- <br /> ZONING DISTRICT PARCEL SQ FOOTAGE PROPOSED PROJECT: New Structure/Addition <br /> R-3 Residence 29362 Description:TEARDOWN REBUILD SFR CONSTRUCT <br /> District BOATHOUSE <br /> App for a Boathouse; App for a Residential Struct SEWER , V <br /> PROJECT INFORMATION PP PP <br /> Sewer <br /> ure; <br /> REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> 336 El YES IA NO <br /> SHORELAND FLOOD ZONE WETLANDS <br /> ® YES 0 NO 0 YES ® NO 0 YES ® NO f- <br /> Existing Impervious Proposed Impervious qtr y <br /> Sq.Ft 6157 Sq.Ft 3771 <br /> Setback from Ordinary High Water Mark Water Body Name - <br /> 58 LAKE KEGONSA " 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 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 Si t <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. Fr4 0)5 a <br /> OFFICE USE ONLY (form version 01.01.00) <br /> DATE ISSUED INITIALS INSPECTION DATE INITIALS <br /> 08/31/2017 HJH3 <br /> DATE REVIEWED INITIALS <br />