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ZONING PERMIT NO. <br /> DANE COUNTY ZONING PERMIT DCPZP-2021 00298 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ALLISON RAE JAMES (406) 241-7350 <br /> BILLING ADDRESS(Number.Street) ADDRESS(Number,Street) <br /> 7848 DAIRY RIDGE RD <br /> (City,State,Zip) (City.State.Zip) <br /> VERONA, WI 53593 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> AKEEFFER@GMAIL.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0608-183-8590-3 TOWN OF VERONA 18 SW NW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 7848 DAIRY RIDGE RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CSM 03275 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RR-4 Rural 5 Description:17'X 10'SHED 329 - Other <br /> Residential District <br /> Category ® Residential 0 Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> o Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road l] YES 0 NO <br /> SHORELAND FLOOD ZONE WETLAND EC!SW NO. <br /> O YES ® NO 0 YES ® NO D YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 167 <br /> 8 Sq.Ft. Sq.Ft.167 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $3,500.00 <br /> 1 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $66.70 <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: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or �� /—� May 28 2021 <br /> plans submitted will invalidate the permit. Allison James(i ay 28,2021 09:03 CDT) <br /> OFFICE USE ONLY (form version 04.00.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 05/27/2021 PMK2 <br /> ❑ _ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />