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x. <br /> • <br /> A location survey, by a licensed surveyor, is required if your construction <br /> is within 10 feet of a setback line. <br /> • You will need to hire a surveyor to prepare a location survey to verify the construction location. <br /> • The survey shall be done at the time when foundations or basement walls are completed. <br /> • A location survey shall be submitted to the zoning office before continuing work on the project. <br /> • Note:A location survey may add significant cost to your project.Please contact a Wisconsin Licensed Land Surveyor, <br /> • <br /> you may need this if . . . <br /> • <br /> 33' 33' <br /> I Front Ube*«« S 72°57'40" E 254.01' r-susdback"" <br /> • I <br /> I -c .......... <br /> s- io Foot <br /> 0 en <br /> r Needs a <br /> ill <br /> Location ; <br /> Q w I Surrey ,+_a.aa, 3 <br /> Oe 169.8' 0 u.. all <br /> fit - - 107 N �� O %�� O <br /> re h 35. = m..hvg20 . <br /> 1 z <br /> _ _ __:fr.e4r# z####A . co <br /> .0._____,..r.te N 72°57'40" W <br /> 33' 33' I <br /> 1. I,the undersigned,hereby make application for a zoning permit only for the location and the work described herein and <br /> certify to the accuracy of that information.I further certify I am the property owner,or a duly authorized representative, <br /> and may sign this permit application on behalf of the owner(s)of said property,and I have read and understand all of <br /> the conditions of this permit and will construct the project in compliance with those conditions.I understand that failure <br /> to provide accura�9nformation or to comply with any provisions of the permit renders it mill and void and may result in an <br /> i enforcement action. <br /> I <br /> 2. 1,the undersigned,hereby consent to the entry on the permitted premises by zoning inspectors of the Dane County <br /> Department of Planning&Development to determine compliance with the county's zoning ordinances.This consent is <br /> valid for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of <br /> compliance or until earlier revoked in writing by the owner of the property.. <br /> PRINT: Owner/Agent DATE: <br /> k01( /M._ CO3-re".,i' 1 . s —-r/s-- <br /> SIGNATURE: Agwg <br /> ._ ;.j-inA-"(--e--.. Gf-R,C-Ai; <br />