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DANE COUNTY ZONING PERMIT DCPZP2022T00664 Page 1of2 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JUSTIN BEREZOWITZ (414)303-7616 Jason Thomas Homes LLC (608) 203-5592 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 9520 DREGERS WAY 7521 Hubbard Ave <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 Middleton, WI 53562 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ssadowski1590 @outlook.com michelle @jasonthomashomes.com <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0607-083-8440-0 TOWN OF SPRINGDALE 8 SW NE <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address Is 2793 TOWN HALL RD <br /> subject to field verification.) <br /> !LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 3 CSM 15133 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RR-2 Rural 2.52 Description:4 bdrm sfr 101 -SFR(detached) <br /> Residential District <br /> Category 21 Residential El Comrnerda! E] Agricultural SEWER SANITARY PERMIT NO. <br /> Other: <br /> Private 13202200283 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road <br /> I] YES ® NO <br /> SIIORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> Q YES ya NO E] YES ® NO El YES VI NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 4006 <br /> 23 Sq.Ft. 1518 Sq.Ft.2488 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $974,967.00 <br /> 1 Sq.Ft. Sq Ft. PERMIT FEE <br /> $450.60 <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. 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 SIGN,TURE: O er/Agent DATE: <br /> Ordinances.Any unauthorized change from the information or 1 �� <br /> plans submitted will Invalidate the permit. "'�-`,,_____ r\ 'Li-1 e <br /> OFFICE USE ONLY (form version 04.00.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 11/14/2022 SCW1 <br /> El YES ® NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: k-rr'yr1;7r.= . <br />