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Application Number: APP-34477 DANE COUNTY ZONING PERMIT Page 1 of ZONING PERMIT NO. ZP20090259 • OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE TATE TR, THOMAS A&ARDELLE N (608)770-0090 WOODY'S MHT. (715)213-5051 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 900 BUFFALO RIDGE LN 5441 KALESEY CT. (City,State,Zip) (City,State,Zip) WAUPACA,WI 54981 WAUNAKEE,WI 53597 E-MAIL ADDRESS E-MAIL ADDRESS PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0911-144-8002-0 BRISTOL 14 SE NE II/2(•1J 4 AIWA DI ii 14* HOUSE NO ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject to field verification.) LOT BLOCK C.S.M.NO.et PLAT NAME METES AND BOUNDS: METES AND BOUNDS ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New ❑Addition/Alteration CENSUS CODE A-1 43.94 Descdption:BREAK ROOM FACILITY TO BE USED FOR HIRED FARM HELP 329 - OTHER CATEGORY ❑Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other: ❑Public ❑Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION C ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO. Lives No ❑Yes No ❑Yes No HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 12 2090 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 2,000.00 1 PERMIT FEE Sq.Ft. Sq.Ft. $ 207.00 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 County SIGNATU- •caner g ,t D•TE: Ordinances.Any unauthorized change from the information / --/-0 or plans submitted will invalidate the permit A 4 OFF!::E USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE,/ / tic INITjG�S ❑Yes1 No 01 Jun 2009 DJE1 /J �/�L DATE REVIEWED INITIALS 2nd INSPECTION DATE /� INITI Initials: ^/20 v / Conditions: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MObIFICATION TO airi T REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND 'j' f t MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIAL''f r 2. ACCESSORY BUILDING-NO COMMERCIAL: THIS BUILDING SHALL NOT BE USED FOR ANY BUSINESS OR COMMERCIA URPOSE. 0 6:/e545-112(12/05) GCS-multi' r r 6/i/o �� o ��' j[l"Ill•�/� „Of' 9/641