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Ap•lication Number:APP-38919 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090705 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JESUS MUACILLAS (608)770-0090 RON WOOD (608)770-0090 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 5441 KALESEY CT#25 5441 KALESEY COURT#98 <br /> (City,State,Zip) (City,State,Zip) <br /> WAUNAKEE, WI 53597 WAUNAKEE,WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0808-224-8190-3 SPRINGFIELD 22 SE NE <br /> a:Z•1 a 4;714W:1'111 it 41111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New gI Addition/Alteration CENSUS CODE <br /> R-4 5.4 Description:l0'X25'PATIO COVER 434 - RES ADD <br /> CATEGORY ,Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ottier: 10'X25' PATIO COVER ❑Public 4 Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> A ❑Yes ❑No <br /> SHORELAND FLOOD ZONE ��yrtt WETLAND EC/SW NO. <br /> ❑Yes ,em No Oyes X�I No ❑Yes X1 No <br /> HEIGHT(In Feet) BASEMENT lst FLOOR TOTAL SQUARE FEET <br /> 10 250 250 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO OF STORIES 2nd FLOOR 3rd FLOOR $ 1,000.00 <br /> PERMIT FEE <br /> 0 Sq.Ft. Sq.Ft. $ 69.00 <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&Agent hereby agree to comply with all Dane County SIGNATU r • Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information '•) <br /> or plans submitted will invalidate the permit. ■ rMP 6 //' 'G` <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes A No 06 Nov 2009 pmk2 <br /> 7,j°' DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT <br /> Conditions: REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COU ' ZONING. THIS PERMIT SHALL BE NULL AND VOI IF ANY 1 <br /> MODIFIC ION ARE MADE WITHOUT)THE EXPRESSSWWRI EN •PPROVAL OF DANE COUNTY ZONING.INITIALS./ <br /> 2. SURV Y�DVISOR�NOTE. A L CATIONSURV ' AY BE REQUIRED TO VERIFY THAT THE <br /> BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. <br /> 545-112(12/05) GCS-single <br />