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fry Ill:talUI I IN11.11111JCI./irr-JO'+J I <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090651 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> PAUL BREDESON (608) 798-2533 LOREN IMHOFF (608)831-1900 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 3250 VALLEY SPRING RD PO BOX 795 <br /> (City,State,Zip) (City,State,Zip) <br /> MT HOREB, WI 53572 MIDDLETON, WI 53562 <br /> E-MAILADDRESS E-MAILADDRESS <br /> LIH @LORENIMHOFF.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0707-344-9500-4 CROSS PLAINS 34 SE SE <br /> Li;lei»it ►'IA'1D1 l 44 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (A ssignmto field verificadtion s is subject 3250 VALLEY SPRING RD <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New g]Addition/Alteration CENSUS CODE <br /> A-1 EX 9 Description:SCREENED PORCH ADDN 434 - RES ADD <br /> CATEGORY X)Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> CI Other:SCREENED PORCH ADDN ❑Public gJ Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> CI Yes X No CI Yes Yes ,r]I No ❑Yes A No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 13 256 256 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 15,000.00 <br /> PERMIT FEE <br /> 1 <br /> Sq.Ft. Sq.Ft. $ 70.00 <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 SIGNAT R • Owner/Ag ilk DATE: <br /> Ordinances.Any unauthorized change from the information D I�• Q6 9 <br /> •or plans submitted will invalidate the permit .r <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st IN E_CTI N I'TE INITI LS <br /> ❑Yes n q ■0 09 Oct 2009 SCW1 1 (( C b <br /> DATE REVIEWED INITIALS 2nd ECTI N DA E INITIALS <br /> Initials: ,� <br /> • 11? I to <br /> 1.THI V.PPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PR SENTED. ANY MODIFICATION TO THE PROJECT <br /> Conditions: REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID .- ,NY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS ' in <br /> 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THA THE <br /> BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. <br /> 545-112(12/05) GCS-single <br />