DCPZP-2009-00123 - Laserfiche WebLink

Home Browse Search

Ap.Iication Number:APP-33357 :DANE COUNTY ZONING PERMIT ZONING PERMIT NO. ZP20090123 OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE CYNTHIA DORN (608)242-0089 SAME AS OWNER BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 4996 BULTMAN RD (City,State,Zip) (City,State,Zip) MADISON, WI 53704 E-MAIL ADDRESS E-MAIL ADDRESS CSD @MADISONLIFE.COM PARCEL NO. TOWNSHIP SECTION y4 1/4 1/4 0810-341-8660-7 BURKE 34 NE NW J(.1 a 4 A ilaA'l'l N 441E/HOUSE NO. ST.DIRECTION STREET NAME ST TYPE (Assignment of verification.)address/is subject 4996 • BULTMAN RD LOT BLOCK C.S.M.NO.91 PLAT NAME METES AND BOUNDS: METES AND BOUNDS ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New RI Addition/Alteration CENSUS CODE A-1 1.25 Description:FRONT ENTRY STEPS 434 - RES ADD CATEGORY 23 Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑other:FRONT ENTRY STEPS XI Public ❑Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION C ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑Yes )4 No 1:1 Yes Yes I No ❑Yes )4 No — HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 3 70 70 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3r_i FLOOR $ 12,000.00 PERMIT FEE 1 Sq.Ft. Sq.Ft. $ 55.00 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 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 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 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. 2. I,the undersigned,hereby certify that: • I have made a diligent inquiry into the applicability of any official map to the applicants'land; • No such official map is applicable,or,if such map is applicable,the approval of the appropriate city or village has been obtained; • I have not relied upon any statements of County employees in giving these assurances; • I understand the possible adverse consequences of erecting any structure within an officially mapped area without the proper approval of the city or village involved.Any zoning permit issued for a property located within an official mapped area for which the applicant has not obtained the proper permit from the appropriate village or city shall be null and void. __\„, N) `'A 44._vwn€r- pe edc r t-cjz) 3. I, the undersigned, hereby consent to the entry on the permitted premises by zoning inspectors of the Dane County Department of Planning & /r o Development to determine compliance with the county's zoning ordinances.This consent is valid for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of compliance or until earlier revoked in writing by the owner of the property. Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: Ordinances.Any unauthorized change from the information Q or plans submitted will invalidate the permit _ � cJ OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS ❑Yes X No 10 Apr 2009 CHS1 DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE Conditions.' PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF AN IFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. INITIALS 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. 545112(12!05) GCS-single y- ��* `}'�}�09 --Ail 5fiy (�I /p9—holes co It