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DANE COUNTY ZONING PERMIT ZONING PERMIT NO. Page 1 of 2 <br /> DCPZP-2019-00136 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> BRIAN P BACH (608) 381-2111 <br /> BILLING ADDRESS(Number,Street) <br /> ADDRESS(Number,Street) <br /> 404 NELI CT <br /> (City.State.Zia) (City.State.Zip) <br /> DEERFIELD, WI 53531 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> gotmumps@live.com <br /> PARCEL NO. <br /> TOWNSHIP SECTION 1/4 1/4114 <br /> 27 NW NW <br /> 0712-272-8810-7 TOWN OF DEERFIELD <br /> STREET NAME ST.TYPE <br /> ST.DIRECTION <br /> PROPERTY ADDRESS HOUSE NO. NELI CT <br /> (Assignment of new address is 404 l <br /> subject to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME CSM 02630 <br /> ZONING DISTRICT PARCEL iARCEL ACREAGE PROPOSED PROJECT. Alteration to existing building CENSUS CODE <br /> RR-4 (Rural 5 Description:ADDN TO SFR. 1 BR ADDED ON 1ST FLOOR,NO 434- Residential Addition <br /> Residential, 4 to 8 ROOMS ADDED ON SECOND FLOOR.REVISED 12-12-19 <br /> —• WER SANITARY PERMIT NO. <br /> Residential ❑ Commercial ElAgncu',tural SEAPPROVED BY <br /> Category ❑ Private <br /> 0 Other: SANITARIAN <br /> ROAD CLASSIFICATION REZONE NO. C U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road ❑ YES 0 NO <br /> SHORELAND FLOOD ZONE <br /> WETLAND EC'SW NO. <br /> YES 0 NO ❑ YES ® NO ❑ YES 0 NO TOTALSOUAREFEET <br /> HEIGHT(In Feet) <br /> 168 <br /> BASEMENT 1st FLOOR FET <br /> 21 sq.Ft.637 Sq.Ft. 1445 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR <br /> 3rd FLOOR $70,000.00 <br /> PERMIT FEE <br /> 2 sq.Ft.86 Sq.F` $262.60 <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.ooFoac cmore ontnformation,e act Department of visit <br /> NaturDaleResoueces Service Natural <br /> Center Resources web page at <br /> www.dnr.state.wi.us <br /> 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/Ag%t DATE: <br /> Ordinances.Any unauthorized change from the information or ' �� --/(' <br /> plans submitted will invalidate the permit. �.. <br /> OFFICE USE ONLY (form version 04.00.00) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE . 6 CANITIALS 51 J <br /> 04/30/2019 2nd INSPECTION DATE INITIALS <br /> ❑ YES ® NO DATE REVIEWED SCW1 <br /> 1 <br /> INITIALS 7—A 1—a\ St. of <br /> Initials:_ _ cJ <br />