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• /14,/ IIUdUVAI INUIIILGI./1rr-Jo'F Iv <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090648 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> PATRICK RICHGELS (608)219-9743 S&B CONSTRUCTION OF SAUK PR,IN (608)225-9217 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 8689 AIRPORT RD 614 SNYDER DR., <br /> (City,State,Zip) (City,State,Zip) <br /> MIDDLETON, WI 53562-4147 DANE, WI 53529 <br /> E-MAIL ADDRESS E-MAILADDRESS <br /> PAT @RICHGELS.COM SSMEIER @TDS.NET <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-064-8100-7 MIDDLETON 06 SE NE <br /> •J(•] 4:i 1 c' '10]:1 * HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 8689 AIRPORT RD <br /> LOT BLOCK C.S.M.NO.2r PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 04641 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New XI Addition/Alteration CENSUS CODE <br /> A-1 5.25 Description:BEDROOM ADDN 434 - RES ADD <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other:30 X 40 BEDROOM ADDN ❑Public ,f41 Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes ❑No <br /> SHORELAND �7 FLOOD ZONE WETLAND EC/SW NO. <br /> CI Yes )4 1�S No ❑Yes No ❑Yes xi No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 17 1200 1200 2400 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR fir FLOOR $ 9,500.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 230.00 <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 SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information Y (T ( vl \ }� to/Wog <br /> or plans submitted will invalidate the permit: r/I 'w� <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTIO DAT INITI <br /> A Yes ❑No 08 Oct 2009 SCW1 Ile �� �CU <br /> Initials: ka-- <br /> DATE R0EV-WVD -0 ? INITIALS 2nd INSPECT! 6b INITIA <br /> P) 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT <br /> Conditions: REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF NY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS_�pQ <br /> 2. SURVEY REQUIREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH <br /> ZONING ORDINANCE SETBACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND <br /> SURVEYOR, AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE II <br /> 545-112(12/05) GCS-single <br />