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Ap•lication Number:APP-34248 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090233 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JOHN ALME (608)873-1975 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 2448 LESLIE RD <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0511-211-9320-7 DUNKIRK 21 NE SW <br /> J:(.1'J 4 a r'/a D]'1 4 441E/HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 2448 LESLIE RD <br /> LOT BLOCK C.S.M.NO.Qr PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 02281 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New iia Addition/Alteration CENSUS CODE <br /> A-1 EX 2.3 Description:REPLACING FLAT ROOF WITH 5/12 PITCHED ROOF OVER FAMILY ROOM. 434 - RES ADD <br /> CATEGORY X Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: ❑Public Xi Private <br /> ROAD CLASSIFICATION REZONE NO C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes ❑No <br /> SHORELAND �1 FLOOD ZONE WETLAND �1 EC/SW NO. <br /> ❑Yes X �y1 pl <br /> No ❑Yes /y No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 170 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 10,000.00 <br /> PERMIT FEE _ .._ <br /> 1 Sq.Ft. Sq.Ft. <br /> $ 63.00 <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 o a <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 SIGNATURE: Owner/Agent a 0 DATE: <br /> Ordinances.Any unauthorized change from the information t-I "�`ipu -n-61 <br /> or plans submitted will invalidate the permit <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPE TION D6WE INITIALS <br /> ❑Yes ;41 No 21 May 2009 DJE1 / ./z.8/JZ -c <br /> DATE REVIEWED INITIALS 2nd ECTIO TI,p DATE INITI <br /> Initials: CD t`9(( S� //2 D/lb <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. 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 . Y DIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS <br /> 545-112(12/05) GCS-single - <br />