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DCPZP-2009-00675
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DCPZP-2009-00675
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DCPZP-2009-00675
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Ap•lication Number:APP-38649 <br /> • ' DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090675 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DENNIS SMITHBACK (608)764-5859 SAME AS OWNER (608)345-3789 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 575 LONDON RD <br /> (City,State,Zip) (City,State,Zip) <br /> DEERFIELD,WI 53531 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0712-274-9840-0 DEERFIELD 27 SE SE <br /> 2 1']JI a 1' 1'1'l N 4 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 567 LONDON RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 3 CERTIFIED SURVEY MAP: CSM 10609 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New M Addition/Alteration CENSUS CODE <br /> LC-1 1.2 Ni escription:90'X17 SHED ADDITION 328-OTHER NON-RES <br /> CATEGORYt ❑Residential 1r71 Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑ <br /> Clay: X17 SHED ADDITION t 3 0` X 1 ❑Public )EJ Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C 8493 ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes JAI No ❑Yes No ❑Yes ,eat No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 1770 1770 <br /> 15 Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 2,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 204.00 <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 SI RE: Owner/Agent I DATE: <br /> Ordinances.Any unauthorized change from the information ► <br /> or plans submitted will invalidate the permit. /Z �G /6.a/ <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECT! N DAT INIT LS J( <br /> ❑Yes I No 21 Oct 2009 pmk2 /6 29/0? kL1 <br /> DATE REVIEWED INITIALS 2nd INSPE ION D1( INI'[;y�l,S._ <br /> Initials: // l/Qr/ +C�� <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT <br /> Condit ions: REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND D IF ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS <br /> 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE <br /> BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. <br /> 545-112(12/051 GCS-single "" rosfs 1 t a <br /> 2 �/D Na eod1iVa (/I�,��Cs Sei 4 - 1612-911a ~ e , <br />
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