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DANE COUNTY ZONING PERMIT D ZONING PE 17-00570 Page l oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> SNYDER SURVIVOR'S TR,MARY E (608)846-7024 Peter Snyder (608)358-3955 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 5396 HAHN RD 900 Allison ST., <br /> (City,State,Zip) (City,State.Zip) <br /> DEFOREST,WI 53532 Sun Prairie,WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> . petersnyder @hotmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0711-223-9500-1 TOWN OF COTTAGE GROVE 22 SW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 3827 Laudon RD <br /> subject to field verification.) <br /> LOT 'BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> A-1 Ex Exclusive Ag 20 Description:ag accessory bldg - 328-Other Non-Residential <br /> District <br /> Category ❑ Residential ❑ Commercial ® Agricultural SEWER SANITARY PERMIT NO. <br /> Private no sanitary fixtures <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road D 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 /> 2880 <br /> 14 Sq.Ft Sq.Ft 2880 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $14,000.00 <br /> 1 Sq.Ft Sq.Ft PERMIT FEE$0.00 <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 zoni • •rdinces. <br /> 1 <br /> Owner&Agent hereby agree to comply with all Dane County SIG - } • ' neri' sent DAT : � <br /> Ordinances.Any unauthorized change from the information or ili /l f <br /> plans submitted will Invalidate the permit. <br /> OFFICE USE ONLY (form version G3.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/31/2017 SCW1 <br /> ❑ YES El NO DATE REVIEWED INITIALS INITIALS S 2nd INSPECTION DATE INmALS <br /> Initials: C\)C o/II S l <br />