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DANE COUNTY SHORELAND ZONING PERMIT DZONING CPSHL-2018-00014 <br /> 00. Page l oft <br /> DCPSHL-2018-00014 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ROBERT C ROTH (608)509-2721 KING CONSTRUCTION INC (608)225-0432 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 7825 FLYNN DR W3010 SAND CRANE DR <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 BELLEVILLE, WI 53508 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> AKING @HOTWIRE.NET <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0508-072-8000-2 TOWN OF MONTROSE 7 NW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7825 FLYNN DR <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL SO FOOTAGE � * <br /> PROPOSED PROJECT: New Structure/Addition <br /> A-1 Ex Exclusive Ag 731000 Description:DETACHED RESIDENTIAL ACCESSORY BUILDING »` <br /> 30 X 40 W/8'LEAN-TO <br /> District >�. i <br /> r <br /> PROJECT INFORMATION App for a Residential Structure; SEWER <br /> Septic 7 4 <br /> REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION ,o,,,..:, ,,,,,, a ` , <br /> YES ® NO i i .. M! T a' <br /> SHORELAND FLOOD ZONE WETLAND <br /> ® YES 0 NO D YES ® NO 0 YES ® NO m �. �� r §� <br /> Existing Impervious Proposed Impervious � `� n� � „ 1."tc. <br /> . t S ? � 1t <br /> Sq.Ft.7143 Sq.Ft.8663 � 4 $�` 'e" �5 <br /> gyp; � <br /> I u � :� s -,�r L k Nt a=4 �W A - : . <br /> -Setback from Ordinary High Water Mark Water Body Name � ;PERMIT FEE FLYNN CREEK h - - _ 40 ,., <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 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 zoning ordinances. <br /> Owner&Agent hereby agree to comply with all Dane County SIGNAT RE: Ow er/A•ent DATE: <br /> Ordinances.Any unauthorized change from the information or - <br /> plans submitted will invalidate the permit. ,=tires 3 20(4 <br /> OFFICE USE ONLY (form version 02.00.00) <br /> DATE ISSUED INITIALS INSPECTION DATE INITIALS <br /> 03/20/2018 HJH3 <br /> DATE REVIEWED INITIALS <br /> • <br />