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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Pagelof2 <br /> DCPZP-2018-00232 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> GOLDEN GREEN PROPERTIES LLC (262) 854-5072 TED GEMENT (262) 854-5072 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 1840 BELOIT AVE 11800 BURLINGTON ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> JANESVILLE, WI 53545 KENOSHA, WI 53144 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> TED@ GOLDENOILCOMPANY.COM TED@ GOLDENOILCOMPANY.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0611-093-8425-0 TOWN OF PLEASANT SPRINGS 9 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2763 COUNTY HIGHWAY N <br /> subject to field verification.) <br /> LOT C.S.M.NO.or PLAT NAME <br /> 1 IBLOCK <br /> CSM 14726 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> C-2 Commercial 5.7 Description:PYLON SIGN 329 - Other <br /> District <br /> Category ❑ Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> El Other:PYLON SIGN Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> A-US or State Highway 11194/1900 2389/1284 ® YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ❑ NO ❑ YES ® NO ® YES ❑ NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 100 Sq.Ft. Sq.Ft. <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $0.00 <br /> PERMIT FEE <br /> Sq.Ft. Sq.Ft. $100.00 <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 SIGNATURE: O . r/• - nt DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. �`A <br /> OFFICE USE ONLY (form version 04.00.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 05/21/2018 PMK2 <br /> ll YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 7-!1 <br />