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0- Application Number:APP-38220 <br /> ZONING PERMIT NO. <br /> DANE COUNTY ZONING PERMIT Page 1 of 2 ZP20090632 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JUSTIN JOHNSON (608)767-2919 SAME AS OWNER (608)209-1238 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 6382 OLD SETTLERS RD <br /> (City,State,Zip) (City,State,Zip) <br /> MAZOMANIE,WI 53560 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JTJ6969@SBCGLOBAL.NET <br /> PARCEL NO. TOWNSHIP SECTION l/4 1/4 1/4 <br /> 0807-052-8100-1 BERRY 05 NW NE <br /> J:fil J 4 1-.1'1'7 1 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 6382 OLD SETTLERS RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 03300 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New ❑Addition/Alteration CENSUS CODE <br /> A-1 EX 5.84 Description:32'X5a'DETACHED GARAGE 438 - GARAGE <br /> CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑other:32'X54'DETACHED GARAGE CI Public Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C <br /> Oyes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> Oyes No ❑Yes No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 16 1728 1728 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 25,000.00 <br /> 1 PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 180.00 <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 /j/,Z/C <br /> or plans submitted will invalidate the permit <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTIN DAT INITIAL <br /> ❑Yes Xi No 02 Oct 2009 mkt Jb <br /> DATE REVI WED INITIALS 2nd INSP O ATE INITIA_ LS t <br /> Initials: ���IDek, ' '' 1 .5 0 ��9ll�A`�/ <br /> Conditions: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESE TED. ANY MODIFICATION TO THE PROJECT <br /> REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID lF NY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS <br /> 2. ACCESSORY BUILDING-NO COMMERCIAL: THIS BUILDING SHALL NOT BE <br /> USED FOR ANY BUSINESS OR COMMERCIAL PURPOSE. <br /> 545-112(12/05) GCS-multi <br />