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DANE COUNTY ZONING PERMIT PERMIT NO. <br /> Page 1of 2 <br /> OWNER INFORMATION AGENT/'CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGEN1-CONT t'RACTOR NAME <br /> PHONE. <br /> JOHN E KLAUS (608)839-3173 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 2730 GASTON RD <br /> (City,State.ZIP) (City,State,Zip) <br /> COTTAGE GROVE,WI 53527 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JKL.AUS YAHOO.COM <br /> PARCEL NO. TOWNSHIP SECTION 114 114 914 <br /> 5 0711-051-8830-2 TOWN OF COTTAGE GROVE NE W <br /> PROPERTY ADDRESS HOUSE.NO. ST.DIRECTION STREET NAME ST.TYPE <br /> ( n t of new address 2730 GASTON RD <br /> eject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME. <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL.ACREAGE PROPOSED PROJECT: Allerationto existing building CENSUS CODE <br /> FR-1 Single Family 1.23 D n:FRONT DECK WITH STEPS 434-Residential Addition <br /> Residential District <br /> Catego <br /> ry EZI Residential El Commercial 0 Agricultural SEWER SANITARY PERMIT NO. <br /> Private <br /> ri Other: 1 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C To m Road <br /> i Cl YES ril NO <br /> SHORELAND FLOOD ZONE WETLAND ECISW NO. <br /> 13 YES ® NO [ YES gl NO [3 YES Fiti NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 184 <br /> 2.3 <br /> Ft. <br /> .Ft <br /> PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $3,000.00 <br /> ISq.FL ;PERMIT FEE <br /> Sq.Ft <br /> $68.40 <br /> I,the undersigned, am the owner of the property or an authorized actingonbehalf of the owner of <br /> � agent <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 <br /> hereby€onsent to the entry on the permitted premises by Dane County zoning inspectors for the <br /> purposes of determining compliance with the zoning ordinances. <br /> ii <br /> Owner&Agent hereby agree to comply with all Dane minty SIGNATURE: ' �' n If DATE: <br /> .Any unae odzed change from the information �j <br /> pans submitted will invalidate the permit /0 JO') 20Z <br /> OFFICE USE ONLY (form version 04.00 01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS .1st INSPECTION DATE INITIALS <br /> 06/08/2021 SLJ3 <br /> [3 YES 0 NO /DATE REVIEWED INITIALS ,2nd INSPECTION DATE INITIALS <br /> r <br />