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DANE COUNTY ZONING PERMIT DCPZP 20 PERMIT 00024 Page of <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JEFFREY C BALL (608)213-9068 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 81 FAIR OAK RD <br /> (City,State,Zip) (City,State,Zip) <br /> DEERFIELD, WI 53531 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> jeffba1161@gmail.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0712-244-9285-0 TOWN OF DEERFIELD 24 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is <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 13.09 Description:ag accessory building 121 @ acres a1-ex ok per rwl 438-Garage <br /> District no sanitary <br /> Category ❑ Residential ❑ Commercial ® Agricultural SEWER SANITARY PERMIT NO. <br /> Private no fixtures <br /> ❑ Other. <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES o NO ❑ YES 21 NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 608 <br /> 12 Sq.Ft. Sq.Ft.608 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $15,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $95.60 <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 /> • <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 SIG I j O er/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or / Y plans submitted will invalidate the permit. / <br /> OFFICE USE ONLY (form version 03.01.02) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 01/31/2018 SC W 1 <br /> ❑ Y ® NO DATE REVIEWED ' / INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: L /3!/ 1(Q l� . 9_0- <br /> `- <br />