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0 BIRRENKOTI SURVEYING INS <br /> ,�� Land Surveying and Soli Testing DANIEL V. BIRRENKOTT <br /> Registered Land Surveyor•Certified Soil Tester <br /> P.O.Box 237. 1677 N. Bristol Street•Sun Prairie,WI 53590•(608)837.7463 •Fax(608)837.1081 •www.birrenkottsurveying.com <br /> Client Name: Du,2r,./ Cci 4 To,,., ,�v/c.vta , Date: /—8 -/D <br /> Job Number: O jp 5/VS— ZP Number: 9O7o8 <br /> Legal Description: L0 T 27 SAvAa.6,141-1 l/.4 4-4-E 7/1 T L,.r Sit"'A4/14 A., ac,44 G. , ' Z <br /> Site Address: V4-c.k.. 80,40 <br /> LOCATION VEY C E _ ���,�,1S <br /> (PROVIDE A COPY TO YOUR SURVEYOR) <br /> A Dane County Location Survey is not exempt from the minimum standards for property surveys, <br /> Chapter A-E 7 of Wisconsin Administrative Code. All of the items listed on this checklist must be <br /> included for Dane County Zoning Division acceptance. <br /> X CONVENIENT SCALE (1"= 10' , 20' ,30' 40' , 50' , 60' , 100' , 200') A-E 7.05 (1) <br /> K NORTH ARROW AND REFERENCE NOTE A-E 7.05 (2) <br /> X BEARINGS AND DISTANCES OF BOUNDARIES OF PARCELS TO THE NEAREST 30 <br /> SECONDS AND 1/100"'FOOT A-E 7.05 (5) <br /> X BOUNDARY MONUMENT SYMBOLS WITH LEGEND OR NOTE INDICATING FOUND <br /> OR PLACED A-E 7.05(4) ._ <br /> 0`' N ` <br /> ene�li � <br /> X LEGAL DESCRIPTION (Description must commence from a VSPL S,.cgk-nel,or sting-,i <br /> platted lot corner) A-E 7.05 (5), A-E 7.04 <br /> X "SURVEYED FOR"NOTE A-E 7.05 (5) �� -Si- , <br /> X _ �,v; .u,�� <br /> DATE OF SURVEY A-E 7.05 (5) -1/1/ ,A- <br /> I, .. C`' Pn',f��` <br /> X SURVEYORS CERTIFICATE WITH STAMP OR SEAL AND SIG'NATJ4 44 ci. t rtify <br /> "this survey is correct to the best of surveyor's knowledge and belief") A-. VI¢) , ` <br /> X ALL NECESSARY SETBACKS AND DISTANCES FROM STRUCTURES REQUIRED BY <br /> CONDITIONS OF PERMIT. MAP MUST ALSO NOTE PERMIT NUMBER g l j 4 <br /> DCO 10.01(30m), 10.25(3)(a)] <br /> THE SURVEYOR IS RESPONSIBLE FOR FILING THE SURVEY MAP IN TH °EFC IYi''°i=i3'r a Ld i.LO A211. <br /> SURVEYORS OFFICE WITHIN 60 DAYS OF COMPLETION. A-E 7.05(7), ss59.45(1)b <br /> Surveyor and client may agree, in a signed statement, to exclude monumentation requirement. To do so, <br /> survey map must include a note, which states that an agreement to exclude work from the requirements of <br /> A-E 7 has been made and the names of the parties making the agreement. <br /> All other items are required either by Administrative Code or Dane County Ordinance. <br /> K:\Docs2\Location Survey Checklist.doc <br />