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fry HUdLIUI l INUIIIUCI. i-rr-oouu'# <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090657 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DEAN SCHULZ (608)455-1508 FORSTER CONSTRUCTION LLC (608)219-9098 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 4559 W RUTLAND RD 4458 HILL RD., <br /> (City,State,Zip) (City,State,Zip) <br /> BROOKLYN, WI 53521 OREGON„ WI 53575 <br /> E-MAILADDRESS E-MAILADDRESS <br /> TOM @TOMFORSTERCONSTRUCTION.COM <br /> PARCEL NO. TOWNSHIP SECTION '/4 '/4 1/4 <br /> 0510-304-8240-0 RUTLAND 30 SE NE <br /> I♦J:Z•7»:iCNA•lDI:l#41El HOUSE NO ST.DIRECTION STREET NAME <br /> ST TYPE <br /> (Assignment field verification.) 4559 subject 4559 W <br /> RUTLAND RD <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 11869 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New 21 Addition/Alteration CENSUS CODE <br /> RH-1 2.28 Description:GARAGE AND FAMILY ROOM 434 - RES ADD <br /> CATEGORY XI Residential LI Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other:GARAGE & FAMILY ROOM ❑Public )I Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C 9473 ❑Yes ❑No <br /> SHORELAND FLOOD ZONE �,S WETLAND EC/SW NO. <br /> ❑Yes XI No Li Yes !'1 No ❑Yes X1 No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 13 349 1025 1374 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR 150,000.00 <br /> PERMIT FEE <br /> 1 <br /> Sq.Ft. Sq.Ft. $ 153.00 <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/(g ent DATE: <br /> Ordinances.Any unauthorized change from the information <br /> or plans submitted will invalidate the permit. a /d 3 '07 <br /> j <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes >41 No 13 Oct 2009 SCW1 1' i S'Cr) _[ <br /> � DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: /� 2 (S ' 10 bS <br /> 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 V�D IF__ANY", <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS /f <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(12105) GCS-single <br />