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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1of2 <br /> DCPZP-2021-00333 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> CHARLES L &ANDREA SIEB (608)444-5104 TIM ANDREWS (608)825-7878 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2677 ROLLING VIEW RD 2890 TERRA CT STE 12 <br /> (City.State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> clsieb@gmail.com mail@capitolpool.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0611-291-0718-7 TOWN OF PLEASANT SPRINGS 29 NE NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 2677 ROLLING VIEW RD <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 8 SQUIRE'S ROLLING MEADOWS-1ST ADDITION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> SFR-08 Single 1.24 Description:inground swimming pool 329-Other <br /> Family Residential <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E-All Other <br /> E 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 /> 540 <br /> Sq.Ft. Sq.Ft. <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $0.00 <br /> 0 Sq.Ft. Sq.Ft. PERMIT FEE <br /> $104.00 <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 /> I other penalties or costs. For more information, visit the Department of Natural Resources web page at <br /> www.dnr.state.wi.usor 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 : 0 n, lent D T <br /> Ordinances.Any unauthorized change from the information or / ' <br /> plans submitted will invalidate the permit. <br /> OFFICE USE ONLY (form version 04.00.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/14/2021 SSA1 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />