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• Application Number:APP-35346 DANE COUNTY ZONING PERMIT Page 1 of 2 ZONING PERMIT NO. ZP20090361 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE CHARLES JORGENSEN (608)241-4101 GRANT SIGNS (608)838-7794 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) PO BOX 8352 5119 TERMINAL DR. (City,State,Zip) . (City,State,Zip) MADISON, WI 53704 MCFARLAND, WI 53558 E-MAIL ADDRESS E-MAIL ADDRESS EJORGENSEN @JXE.COM EMARTY @SIGNPRODUCTIONS.COM PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0810-093-8572-0 BURKE 09 SW NW a4 a=1:1 IV/_1 00:1441M HOUSE NO. ST.DIRECTION STREET NAME ST TYPE (Assignment to od ewaddress issubject 4205 ANDERSON RD LOT 'BLOCK C.S.M.NO.or PLAT NAME 2 CERTIFIED SURVEY MAP: CSM 07441 ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ]New ❑Addition/Alteration CENSUS CODE C-2 8.214 Description:27.17'X 11.71'X 62.61' PYLON SIGN 328-OTHER NON-RES �/ CATEGORY Cl Residential )1 Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other:27.17'X 11.71'X 62.61'PYLON SIGN ❑Public l Private ROAD CLASSIFICATION REZONE NO C.U.P.NO. VARIANCE NO. DEED RESTRICTION A 1616 ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO ❑Yes No ❑Yes No ❑Yes No HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 62.61 319 319 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 10,000.00 1 PERMIT FEE Sq.Ft. Sq.Ft. $ 100.00 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. 3. I, the undersigned, hereby consent to the entry on the permitted premises by zoning inspectors of the Dane County Department of Planning & 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 Coun IMF Ordinances.Any unauthorized change from the info,matio �; / or plans submitted will invalidate the permit -7 /3— 9 OFFICE USE ONLY _ /' SURVEY REQUIRED? DATE ISSUED INITIALS st INSPECTION DATE INITIALS Yes ❑No 01 Jul 2009 RLB DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Condition " .THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND V ID ANY MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITI 2. SURVEY REQUIREMENT: A HEIGHT SURVEY IS REQUIRED TO VERIFY COMPLIAN E WITH THE MAXIMUM HEIGHT OF 1006.0 FEET ABOVE MEAN SEA LEVEL(MSL), SECTION 78.03 AND SECTION 78.02 OF THE DANE COUNTY CODE OF ORDINANCES. 545-112(12/05) GCS-multi //1/0�_NQ S1�( �/� J✓�_/C / e.�.e ,, J�) 1 9�r q to 9 - 1 V / /