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parrarmrtarrreagr <br /> SANE COUNTY ZONING PERMIT DCPZP-2021-00402 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME <br /> PHONE AGENT/CONTRACTOR NAME PHONE <br /> PEGGY A GOCHNOUR (832)764-9935 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number.Street) <br /> 3131 WOODS RD <br /> (City,State.zip) <br /> (City.State.Zip) <br /> VERONA,WI 53593 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PGOCHNOUR0115@GMAIL.COM <br /> PARCEL NO. TOWNSHIP SECTION 114 1/4 1/4 <br /> 0608-042-9671-0 TOWN OF VERONA 4 NW SE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is 3131 WOODS RD <br /> subject to field verification.) <br /> LOT BLOCK CS.M.NO.or PLAT NAME • <br /> METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RR-2 Rural 5 Description:DECK 329-Other <br /> Residential District <br /> Category 0 Residential 0 Commercial ❑ Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ <br /> Other: Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> YES 0 NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> YES ® NO ❑ YES ® t.O El YES El NO <br /> HEIGHT(ln Feel) BASEMEN1 1st FLOOR TOTAL SQUARE FEET <br /> 980 <br /> 2 Sq Ft Sq.Ft,980 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $25,000.00 <br /> 1 sq.Ft, Sq.Ft. PERMIT FEE <br /> $148.00 <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 /> 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 SI NAyURE:Owner/ g4nt DATE: <br /> Ordinances.Any unauthorized change from the information or t� <br /> plans submitted will invalidate the permit. /1,46:-Z- '1 / 1— <br /> ;s;at OFFICE USE ON Y. - • • ��L - • 04.00.01) <br /> SURVEY REQUIRED 7 DATE ISSUED INITIALS — 1st INSPECTION DATE INITIALS <br /> 07/14/2021 PMK2 <br /> YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> lr>♦tiail:� <br />