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DANE COUNTY ZONING PERMIT DCPZP-2022-00687 Pagelof2 <br /> Oi NER INFORMATION . AGENT/CON RACTOR INFORMATION : <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> Gary Nolden (608)698-0259 Nolden Construction (608) 513-4300 <br /> BILLING ADDRESS(Number,Street) ADDRESS(Number,Street) <br /> 204 Brooke Dr., 577 West Church St. <br /> 'City.State.Zip) (City,State.Zip) <br /> Belleville, WI 53508 Belleville, WI 53508 <br /> -MA't ADDRESS E-MAIL ADDRESS <br /> gsnolden @gmail.com noldenconstruction @yahoo.com <br /> I PARCEL NO. i TOWNSHIP I SECTION 1:4 1/4 1/4 <br /> 0508-192-6011-0 TOWN OF MONTROSE 19 NW SE <br /> IPROPERTY ADDRESS I HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> ;Assignment of new address is 746 Fritz RD <br /> subject to field verification.) <br /> ..OT BLOCK C.S.M.NO.or PLAT NAME <br /> I 1 CSM 16103 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New Structure/Addition CENSUS CODE <br /> RR-4 Rural 5.04 Cescription:3 bdrm 101 -SFR (detached) <br /> Residential District <br /> Category Ea Residential ❑ Commercial ❑ Agricultural SEWE.R SANITARY PERMIT NO <br /> Private 13202200328 <br /> ❑ Other: <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C-Town Road ❑ YES ® NO <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> 20220361 <br /> C YES 0 NO ❑ YES ❑ NO ❑ YES ® NO <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEE- <br /> 4238 <br /> 29 Sq.Ft. 1272 Sq.Ft.2396 <br /> PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $450,000.00 <br /> 2 Sq.Ft.570 sq. Ft. PERMIT FEE <br /> $473.80 <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 SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the inform ation or <br /> plans submitted will invalidate the permit. 6ri /Z --7 -Z Z <br /> ' OFFICE USE ONLY' (form version 04.00.01) <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> 12/07/2022 SCW1 <br /> ❑ YES 0 NO DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: J <br />