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Application Number:APP-38104 <br /> ZONING PERMIT NO. <br /> DANE COUNTY ZONING PERMIT Page 1 oft ZP20090620 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> KARL PULVER (608)220-4169 SAME AS OWNER (608)220-4169 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 365 PAGELOW LN <br /> (City,State,Zip) (City,State,Zip) <br /> BROOKLYN,WI 53521 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> KPULVER77 @YAHOO.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0510-303-0244-9 . RUTLAND 30 SW NE <br /> -JIaelJ4[ily/c1' P1:44 111111HOUSENO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 365 PAGELOW LN <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 4 PLAT:ACRES GREEN <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ]New ❑Addition/Alteration CENSUS CODE <br /> R-1 .75 Description:26'X40'POLE SHED 438 - GARAGE <br /> CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: ❑Public Private <br /> • <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E ❑Yes ❑No <br /> - <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes No ❑Yes No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT IsIFLOOR TOTAL SQUARE FEET <br /> 14 1040 1040 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 13,000.00 <br /> 1 PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 128.00 <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 8 Agent hereby agree to comply with all Dane County SIGNATURE: Owner/A. DATE: <br /> Ordinances.Any unauthorized change from the information <br /> or plans submitted will invalidate the permit. AP / f Lei 0 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> Al Yes ❑No 29 Sep 2009 SSAI 3 141- i o 1W <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> me- <br /> Initials: /V 3 (�- (0 <br /> Conditions: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PR JECT <br /> REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOI�.fF�NY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS <br /> 2.SURVEY REQUIREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH ZONING ORDINANCE SETBACKS. THE <br /> SURVEY SHALL BE PREPARED BY A REGISTERED LAND SURVEYOR,AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE <br /> FOUNDATION/BASEMENT WALLS ARE COMPLETED,OR IF THE PROJECT DOES NOT INCLUDE FOUNDATION/BASEMENT WALLS,AT <br /> THE TIME THE LOCATION OF THE STRUCTURE IS ESTABLISHED,AND BEFORE ANY OTHER WORK IS DONE. <br /> 545-112(12/05) GCS-multi <br />