Laserfiche WebLink
DANE COUNTY ZONING PERMIT DCPZP-2018-00141 Page of <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DALE R CARMICHAEL 576-0999 JM FREDERICK CUSTOM HOMES 843-2789 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 132 E WILSON ST UNIT 1106 1283 CTH D <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON,WI 53703 OREGON, WI 53575 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0711-264-9915-0 TOWN OF COTTAGE GROVE 26 SE SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3474 SKARSTINDEN RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CSM 13349 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-1A Residence 2.05 Description:SINGLE FAMILY RESIDENCE 101 -SFR (detached) <br /> District <br /> Category 0 Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: <br /> Private 2018-00075 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> 0 YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑ YES 0 NO ❑ YES 0 NO ❑ YES la NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 5979 <br /> 28 Sq.Ft. 1938 Sq.Ft.3363 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $500,000.00 <br /> 2 Sq.Ft.678 Sq.Ft. PERMIT FEE <br /> $498.43 <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 I ATURE: •wner/Ag-j . 'TE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. . `� / 3'•- �� <br /> OFFICE USE ONLY (form version 04.00.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE NITIALS <br /> 04/13/2018 DJE1 <br /> 0 YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: VMS. S L'f <br />