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Ap.lication Number:APP-37187 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090560 <br /> • OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> RICHARD REINES (608)839-4869 SAME AS OWNER (608)445-0567 <br /> BILLINGADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 4686 GASTON CIR <br /> (City,State,Zip) (City,State,Zip) <br /> COTTAGE GROVE, WI 53527 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> 5700GE-3 @HOTMAI L.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0711-042-8230-9 COTTAGE GROVE 04 NW NE <br /> M:]:1.1»aiv/_1,1'1:1*-11111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 4686 GASTON CIR <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CERTIFIED SURVEY MAP: CSM 01726 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New ❑Addition/Alteration CENSUS CODE <br /> R-1 0.47 Description:22'X 16'X 15'GAR ADDN 438 - GARAGE <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: ❑Public ,t4I Private 518169 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ��yy{{ <br /> ❑Yes Xi No ❑Yes ,C)1 No ❑Yes .bl No <br /> HEIGHT(In Feet) BASEMENT ]sue FLOOR TOTAL SQUARE FEET <br /> 345 <br /> 15 345 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 15,100.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 76.00 <br /> 1. I,the undersigned,hereby make application for a zoning permit only for the location and the work described herein and certify to the accuracy of that <br /> information.I further certify I am the owner of the property,or a duly authorized representative,and may sign this permit application on behalf of the <br /> owner(s) of said property, and I have read and understand all of the conditions of this permit and will construct the project in compliance with <br /> those conditions. I understand that failure to comply with any provision of the permit renders it null and void and may result in an enforcement action. <br /> 2. I,the undersigned,hereby certify that: <br /> • I have made a diligent inquiry into the applicability of any official map to the applicants'land; <br /> • No such official map is applicable,or,if such map is applicable,the approval of the appropriate city or village has been obtained; <br /> • I have not relied upon any statements of County employees in giving these assurances; <br /> • I understand the possible adverse consequences of erecting any structure within an officially mapped area without the proper approval of the city or <br /> village involved.Any zoning permit issued for a property located within an official mapped area for which the applicant has not obtained the proper <br /> permit from the appropriate village or city shall be null and void. <br /> 3. I, the undersigned, hereby consent to the entry on the permitted premises by zoning inspectors of the Dane County Department of Planning & <br /> Development to determine compliance with the county's zoning ordinances.This consent is valid for the period commencing with issuance of this <br /> zoning permit and terminating with issuance of a certificate of compliance or until earlier revoked in writing by the owner of the property. <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATU hog nt DATE: <br /> Ordinances.Any unauthorized change from the information G <br /> or plans submitted will invalidate the permit `- , 1-3—oq <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSP Z IO DATE ,j , INITIALS� <br /> Yes ❑No 03 Sep 2009 RLB //�/ <br /> DATE REVIEWED INITIALS 2nd INSPEC ION DATE / /_ O INITIALS <br /> Initials r/ g <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT <br /> Conditions: REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID ANY <br /> MODIFICATIONS ARE M D TROUT THE EXPRESS W ITTEN APPROVAL OF DANE COUNTY ZON G.INIT AL 1 <br /> z/� <br /> 2_3-(3 /� k l t ; c s o ., - 2 20 I�c/��p <br /> URVEY REQUIRE ENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH <br /> ZONING ORDINANCE SETBACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND <br /> SURVEYOR,AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE 0 <br /> ri0(12/05) <br /> ,,GCS Q f` f ? t( 1 <br /> / I /f �> I1 <br /> �'11ekSk,eS / � rx �il� (1 �'5 � �� � � �d/ly/�� p �l� ��OT Skva/�ySwrs ( � JC�!/tr <br />