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Ap•Iication Number:APP-34242 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090232 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> SUSAN BEIL (608)795-2627 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 10363 HUDSON RD <br /> (City,State,Zip) (City,State,Zip) <br /> MAZOMANIE,WI 53560 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0806-161-8080-6 MAZOMANIE 16 NE NE <br /> :toll I it WM:1'1'] l#41/1111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 10363 E HUDSON RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.p PLAT NAME <br /> METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New RI Addition/Alteration CENSUS CODE <br /> A-2 10.2 Description:39'X30'ADDITION TO SHED 434 - RES ADD <br /> CATEGORY V Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other. ❑Public Private <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 /> ❑Yes pm No ❑Yes V No ❑Yes V No <br /> HEIGHT(In Feet) BASEMENT 1tt FLOOR TOTAL SQUARE FEET <br /> 25 1070 1070 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR arA FLOOR $ 6,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 138.00 <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 8 Agent hereby agree to comply with all Dane County <br /> SIGNAT/: Owner ' ,ent DATE: <br /> Ordinances.Any unauthorized change from the information / � <br /> or plans submitted will invalidate the permit Ie • ` / Sd - <br /> •OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTIpN D TE INITIALS <br /> Yes ❑No 20 May 2009 SSA1 / ��f V i <br /> DATE REVIEWED INITIALS 2nd INSP CtttION BOAT INITIALS <br /> Initials: 2_.6 <br /> /o <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PR SENTE . ANY MODIFICATION TO THE <br /> Conditions: PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND <br /> VOID IF ANY ODI ATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS <br /> 2. SURVEY REQUIREMENT: 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 FOUNDATION/ <br /> 545-112(12/05) GCS-single <br />