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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> Page 1of2 <br /> DCPZP-2021-00325 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> AMBER M HUEMMER (608) 279-5424 JEANETTE ACKER (608) 849-6770 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 904 LINDSAY CT 102 N HOLIDAY DR <br /> (City,State,Zip) (City,State,Zip) <br /> COTTAGE GROVE, WI 53527 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> AMBER@THHTREALTY.COM JEANETTE@PREMIERBUILDERSINC.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/41/4 <br /> 0711-074-9125-0 TOWN OF COTTAGE GROVE <br /> 7 SE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 4282 VILAS HOPE RD <br /> subject to field verification.) <br /> LOT BLOCK I C.S.M.NO.or PLAT NAME <br /> 1 CSM 15434 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RM-16 Rural Mixed- 31.47 Description:SFR W/5 BEDROOMS,3 SEASON PORCH,AND 101 - SFR (detached) <br /> Use District DECK <br /> Category ® Residential ❑ Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> Private 13-2021-00145 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> ® YES ❑ NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ® YES ❑ NO ® YES ❑ NO ® YES ❑ NO 5E2021-0188 <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 9724 <br /> 22 Sq.Ft.3205 Sq.Ft.5639 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $870,000.00 <br /> 2 Sq.Ft.880 Sq.Ft. PERMIT FEE <br /> $1,022.40 <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.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 SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or <br /> plans submitted will invalidate the permit. / , r / , ciez/!, 6/14/2021 <br /> OFFICE USE ONLY (form version 04.00.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 06/11/2021 SLJ3 <br /> ❑ YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br />