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Ap•lication Number:APP-38105 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090621 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> ROBERT UPDIKE (608)839-9207 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) �� //'1! �I c-7-7 Y.3 ADDRESS (Number,Street) <br /> �2726 LYMAN LN 5 <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53711 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0911-224-8190-0 BRISTOL 22 SE NE <br /> -,:Z•1 A4:iWM1,191:4 IN HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 2178 BRANCH RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.e PLAT NAME <br /> 1 1 CERTIFIED SURVEY MAP: CSM 09797 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: 0 New ❑Addition/Alteration CENSUS CODE <br /> A-1 1.889 Description:10'X 7.5'X 6'pET STOR SHED 328-OTHER NON-RES <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: ❑Public gI Private <br /> ROAD CLASSIFICATION REZONE NO. C.6.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes 0 N <br /> SHORELAND FLOOD ZONE � WETLAND EC/SW NO. <br /> { <br /> ❑Yes A No ❑Yes . No ❑Yes X1 No <br /> HEIGHT(In Feet) BASEMENT I ig FLOOR TOTAL SQUARE FEET <br /> 6 75 75 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 500.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 56.00 <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 understan 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 fficial map to the applicants'land; <br /> • No such official map is applicable,or,if such map is appli ble,the approval of the appropriate city or village has been obtained; <br /> • I have not relied upon any statements of County employe s in giving these assurances; <br /> • I understand the possible adverse consequences of erecti g 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 I ted 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 pertnitted 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 <br /> or plans submitted will invalidate the permit <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes ❑No 29 Sep 2009 RLB <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: � <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 APPROVA_BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID 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(12/05) GCS-single <br /> i ( ` I t ��j� <br /> w4_11 2, xrw G byDw..�.r /? <br />