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` It Dane Cou ty Planning & Development <br /> 'a W1'4 City-Coun Building, Madison, Wisconsin 53709 <br /> coK __ <br /> Planning <br /> Room 116,608266-4251 <br /> Zoning <br /> Room 116,608266-4266 <br /> CERTIFICATION OF OFFI • Y MAPPED AREAS TO community Development <br /> APPLICANT" LANDS Room 421,608261-9781 <br /> Records&Support <br /> Room 116,608266-4251 <br /> The undersigned applicant for a zo.•11 permit under Chapter 10 of the Dane County <br /> Ordinances thus certifies as follows: <br /> 1. That he or she has made diligent in.;uiry into the applicability of any official map to the <br /> applicant's land. <br /> 2. That no such official map is applic.'.le or,if such map is applicable,the approval of the <br /> appropriate city or village has been obtained. <br /> 3. That the applicant has not relied u.on any statements of County employees in giving <br /> these assurances. <br /> 4. That the applicant understands th, possible adverse consequences of erecting any <br /> structure within an officially mapped area 'thout the proper approval of the city or village <br /> involved. Any zoning permit issued for a • •perry located within an officially mapped area for <br /> which the applicant has not obtained the pro.- permit from the appropriate village or city shall <br /> be null and void. (Ref. §10.25 (6)(b) and(d) U ane County Zoning Ordinance) <br /> Dated this f Z day of (kf C 20°`- at Madison,Wisconsin. <br /> /' <br /> Signed: - / - <br /> i, mac, .� <br /> f6/Witness: <br /> Zoning Permit# ? ' - >0 y <br /> FORMSLIB:CERT MAPPED AREAS • 'PLI'S LAND (12/2003) <br />