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DANE COUNTY ZONING PERMIT DCPZP-2018-00094 Page 1 of 2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> FEBOCK BROTHERS LLC Herman Holzapfel (608) 513-1248 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 3555 STATE HIGHWAY 134 706 Townsend St., <br /> (City,State,Zip) (City,State,Zip) <br /> CAMBRIDGE, WI 53523 Cambridge, WI 53523 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ginghozie @yahoo.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0712-361-9510-0 TOWN OF DEERFIELD 36 NE SE <br /> ,PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3357 State Highway134 <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 14731 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RH-1 Rural Homes 2.237 Description:3 bdrm sfr 101 -SFR(detached) <br /> District <br /> Category 0 Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13201800051 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO, VARIANCE NO. DEED RESTRICTION <br /> A-US or State Highway 11207 ❑ YES NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ® NO ❑ YES Ij NO D YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 5132 <br /> 17 Sq.Ft.2158 Sq.Ft.2974 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $350,000.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $434.90 <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 SIGN U-E: Owner/Age t DATE: <br /> Ordinances.Any unauthorized change from the Information or <br /> plans submitted will invalidate the permit. ✓ 3 J 2-4/ <br /> OFFICE USE ONLY (form version 04.00.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 03/21/2018 SCW1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: /� 3/2.• /l(6, S -1,61- <br />