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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1of2 <br /> DCPZP-2017-00812 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> C MARK SCHROEDER (608) 256-9999 RAINBOWS END RENOVATIONS (608) 256-9999 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 14 SAUTHOFF RD 14 SAUTHOFF RD <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53704 MADISON, WI 53704 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0711-334-8710-5 TOWN OF COTTAGE GROVE <br /> 33 SE NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3250 COUNTY HIGHWAY N <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: Alteration to existing building CENSUS CODE <br /> R-1 Residence 0.931 Description:EAST SIDE REAR DECK 8'X12' 434 - Residential Addition <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B-County Highway 1987-03877 ❑ 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 /> 96 <br /> Sq.Ft. Sq.Ft.96 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR '3rd FLOOR $700.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $114.40 <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 a8 es.Agent <br /> Any unauthorized hors agree to <br /> change with all Dane County SIGNATURE: ()WI1 ent DATE: / 7 <br /> Ordinances.Any unauthorized than a from the information or /y,�,' W/�) <br /> plans submitted will invalidate the permit. <br /> OFFICE USE ONLY (form version 03.01.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ® YES ❑ NO DATE REVI12/21/2017 SLJ3 <br /> REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: OM la�/dk//(Z <br />