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Dale Judd-Chairman , , <br /> Martha Gibson Supervisor TOWwof PrWn4-aSe/ r <br /> Alex Elkins Supervisor 8468 County Highway A i► '1 <br /> Verona,WI 53593 <br /> Ruth Hansen—Clerk <br /> 608-832-8056 <br /> Kristina Gorman-Treasurer <br /> Board Approval for Building Permit <br /> Applicant: 0121 �i3 <br /> Project Address: /4416 /- i.1`444d-et 9 a <br /> Project: l /c, si-kg_of <br /> Project sketch attached to this document )'Yes No <br /> Parcel Number: D Sv 7 - 0 Z V - 1S-/U - <br /> Building site approval based on site visit on this day, chi of A <% , 2d <br /> Site visit attended by Town Board members: <br /> Site visit attended by Planning Commission members: <br /> Date of approval by Planning Commission: cc-- <br /> Date of approval by Town Board: ihc e:X S 20/' <br /> _7474/2Z,(7/0,1- Gret-, 5/03 .3/5-XS <br /> Town Clerk date Town Ch ' person date <br /> This form will be forwarded to the Town Building Inspector by the Clerk. You will also need <br /> to present a copy of this letter to Dane County Planning and Zoning when you apply for a <br /> Zoning Permit. <br /> Town of Primrose Building Inspector: Todd Parkos <br /> 310 N Kenzie St <br /> Barneveld,Wi. 53507 <br /> 608-516-1251 <br /> Todd.parkos @hotmail.com <br /> September 2015 13 <br />