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BIRRENKOTI SURVEYING <br /> l Land Surveying and Soil Testing INS 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: V)YAG-EW ltc-DZgS Date: /- 2U/e, <br /> Job Number: Q?o ryv ZP Number: 2c7o5'70? <br /> Legal Description: LOT % C.S. /1. 6'6 y7, , i NA'% `"/V . Ec.3-8—// <br /> Site Address: (o .QUAD <br /> LOCATION SURVEY CHECKLIST <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. <br /> CONVENIENT SCALE (1"= 10' ,20' ,30' 50' , 60' , 100' , 200') A-E 7.05 (1) <br /> X 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`h FOOT A-E 7.05 (5) y q;E1fF b <br /> BOUNDARY MONUMENT SYMBOLS WITH LEGF,i■1b0NOTE INDICATING FOUND <br /> OR PLACED A-E 7.05(4) <br /> X LEGAL DESCRIPTION(Description must commefice fort a?USPLSS corner or existing <br /> platted lot corner) A-E 7.05 (5), A-E 7.04 <br /> >C "SURVEYED FOR"NOTE A-E 7.05 (5) <br /> X DATE OF SURVEY A-E 7.05 (5) <br /> X SURVEYORS CERTIFICATE WITH STAMP OR SEAL AND SIGNATURE(Must certify <br /> "this survey is correct to the best of surveyor's knowledge and belief') A-E 7.05 (6) <br /> ALL NECESSARY SETBACKS AND DISTANCES FROM STRUCTURES REQUIRED BY <br /> CONDITIONS OF PERMIT. MAP MUST ALSO NOTE PERMIT NUMBER <br /> DCO 10.01(30m), 10.25(3)(a)1 <br /> THE SURVEYOR IS RESPONSIBLE FOR FILING THE SURVEY MAP IN THE COUNTY <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 /> VEg 1 2010 <br /> 1AG& <br /> LINTY PIAhNID EI.OPM <br /> DgeC4 <br />