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DANE COUNTY ZONING PERMIT DCPZP 2018 00409 Page oft <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MICHAEL TATTERSALL (630) 897-3471 JEWELL ASSOCIATES ENGINEERS,INC (608)588-7484 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2069 RICHARD ST 560 SUNRISE DR <br /> (City,State,Zip) - (City,Slate.Zip) <br /> AURORA, IL 60506 SPRING GREEN, WI 53588 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> MHTATTERSALL @GMAILCOM GREG.JEWELL @JEWELLASSOC.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0611-303-4023-4 TOWN OF PLEASANT SPRINGS 30 SW SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 3122 SHADYSIDE DR <br /> subject to field verification.) <br /> LOT C.S.M.NO.or PLAT NAME <br /> 3 'BLOCK <br /> PLAT <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> R-3 Residence .31 Description:TEARDOWN REBUILD DETACHED GARAGE 438 -Garage <br /> District <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Othe Public <br /> r. <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-AII Other <br /> ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ® YES El NO 0 YES ® NO 1] YES 0 NO SE2018-0213 <br /> HEIGHT(In Feel) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 480 <br /> 12 Sq.Ft. Sq.Ft.480 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $20,000.00 <br /> 1 Sq.FL Sq.FL PERMIT FEE <br /> $86.00 <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 OwnerlAgent DATE:; <br /> Ordinances.Any unauthorized change from the information or p <br /> plans submitted will Invalidate the permit. 1I'LLe -0_,-,G ? f 2A�O <br /> OFFICE USE ONLY (form version 04.00.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 08/08/2018 HJH3 <br /> ® YES ❑ NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />