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' Application Number:APP-23001 <br /> • DANE COUNTY ZONING PERMIT Page 1 oft ZONING PERMIT NO. <br /> ZP20080477 <br /> OWNER INFORMATION 1 AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> TROY SCHWENN (608)829-1981 BRIAN CISEWSKI (608)235-4547 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 7915 BLACK RIVER RD 906 N. FAIRBROOK DRIVE <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 WAUNAKEE,WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> TSCHWENN @CHARTER.NET QUALCON @CHARTER.NET <br /> PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-192-5022-3 MIDDLETON 19 NW SW <br /> M:J:t4 LA 4:l!1-/d it it N*1 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (.4ssignment of new address is subject 7915 BLACK RIVER RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 PLAT: PRAIRIE VISTA <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New Zci Addition/Alteration CENSUS CODE <br /> R-1 1.8 Description:34'X27' MASTER BEDROOM ADDITION 434 - RES ADD <br /> CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other.34'X27' MASTER BEDROOM ADDITION ❑public Private 518050 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C 2161 <br /> ❑Yes ❑No <br /> - 1 SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> Yes ❑No ❑Yes No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 19 891 918 1809 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3 rr FLOOR $ 153,000.00 <br /> 1 PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 186.00 <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 ntil earlier yoked 'n writing by the owner of the property. <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATUR- Owner/A nt DATE: <br /> Ordinances.Any unauthorized change from the information <br /> or plans submitted will invalidate the permit ,' 7- Ii- <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTIO INITIAL <br /> ❑Yes XI No 11 Jul 2008 pmk2 r 0 it DATE REVIEWED INITIALS 2nd INSPEC' •• I' E INITIAL <br /> Initials: +�M C- c( D PI '�\ <br /> Conditions: <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESETPf £f A ODIFICATION TO THE PROJECT <br /> REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS P RMIT SHALL BE NULL AND VOID IF ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DA COUNTY ZONING.INITIALS &Ate <br /> 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE <br /> BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. <br /> 545-112(12/05) GCS-multi <br />