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Ap•Iication Number:APP-39056 DANE COUNTY ZONING PERMIT ZONING PERMIT NO. ZP20090722 OWNER INFORMATION 1 AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE ROBERT JOHNSON (608)437-5344 JG DEVELOPMENT (608)437-6181 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 3523 COUNTY HIGHWAY JG N 4070 E. BRIGHAM ROAD (City,State,Zip) (City,State,Zip) BLUE MOUNDS,WI 53517 BLUE MOUNDS,WI 53517 E-MAIL ADDRESS E-MAIL ADDRESS JESSE @JGDEVELOPMENT.COM PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 1/4 0706-343-8001-0 VERMONT 34 SW NE J:fel J 4 all/d DI Dl:1 441111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject to field verification.) 3523 COUNTY HIGHWAY JG LOT BLOCK C.S.M.NO.or PLAT NAME METES AND BOUNDS: METES AND BOUNDS ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New XI Addition/Alteration CENSUS CODE RH-1 38.88 Description:l0'X10'HOUSE ADDITION 328-OTHER NON-RES CATEGORY X Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. U Other: 10'X10' HOUSE ADDITION ❑Public 4 Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION B 7643 ❑Yes ❑No SHORELAND FLOOD ZONE may{ pX WETLAND 1�1 EC/SW NO. ❑Yes X No ❑Yes X No ❑Yes No HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 11 100 100 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 18,000.00 PERMIT FEE 1 Sq.Ft. Sq.Ft. $ 58.00 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 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 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 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. 2. I,the undersigned,hereby certify that: • I have made a diligent inquiry into the applicability of any official map to the applicants'land; • No such official map is applicable,or,if such map is applicable,the approval of the appropriate city or village has been obtained; • I have not relied upon any statements of County employees in giving these assurances; • I understand the possible adverse consequences of erecting any structure within an officially mapped area without the proper approval of the city or village involved.Any zoning permit issued for a property located within an official mapped area for which the applicant has not obtained the proper permit from the appropriate village or city shall be null and void. 3. I, the undersigned, hereby consent to the entry on the permitted premises by zoning inspectors of the Dane County Department of Planning & Development to determine compliance with the county's zoning ordinances.This consent is valid for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of compliance or until earlier revoked in writing by the owner of the property. Owner 8 Agent hereby agree to comply with all Dane County SIG TURE�wner//Agent DATE: Ordinances.Any unauthorized change from the information 6 1-1 or plans submitted will invalidate the permit. --- -$-Se-- V Sc-11/i rn 'e h 1///3/4,-, OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTI N DATE INITIALS ❑Yes X)No 13 Nov 2009 pmk2 f c `■DATE REVIEWED INITIALS 2nd IN ECTI N DATE INITI‘i94)ALS Initials: �V S 6 z�2°'° 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESET TED. ANY MODIFICATION TO THE PROJECT JEECT Conditions: REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF AN MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS .12 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. 545-112(12/05) GCS-single