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17 Application Number:APP-35531 . DANE COUNTY ZONING PERMIT Page 1 oft ZONING PERMIT NO. ZP20090391 OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE MELANIE WAUGH (608)845-9125 ULTIMATE CONSTRUCTION (608)825-4633 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 6371 GOOSE LAKE ST 4827 PIERCEVILLE RD. (City,State,Zip) (City,State,Zip) VERONA, WI 53593 COTTAGE GROVE,WI 53527 E-MAIL ADDRESS E-MAIL ADDRESS PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0608-131-1600-6 VERONA 13 NE NE •J:Z'7 J 4:i CL_\r]4l:l 4/1111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject 6371 GOOSE LAKE DR to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 2 CERTIFIED SURVEY MAP: CSM 03604 ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New 161 Addition/Alteration CENSUS CODE R-1 .4 Description:SCREEN PORCH 16X16 434 - RES ADD CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑other:SCREEN PORCH 16X16 ❑Public Private NA ROAD CLASSIFICATION REZONE'NO. C .U.P.NO. VARIANCE NO. DEED RESTRICTION E ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO. Yes 0 N ❑Yes No ❑Yes No NA HEIGHT(In Feet) BASEMENT 1 FLOOR TOTAL SQUARE FEET 12 256 256 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 20,000.00 1 PERMIT FEE Sq.Ft. Sq.Ft. $ 69.00 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 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 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 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. 2. I,the undersigned,hereby certify that: • I have made a diligent inquiry into the applicability of any official map to the applicants'land; • No such official map is applicable,or,if such map is applicable,the approval of the appropriate city or village has been obtained; • I have not relied upon any statements of County employees in giving these assurances; • I understand the possible adverse consequences of erecting any structure within an officially mapped area without the proper approval of the city or village involved.Any zoning permit issued for a property located within an official mapped area for which the applicant has not obtained the proper permit from the appropriate village or city shall be null and void. 3. I, the undersigned, hereby consent to the entry on the permitted premises by zoning inspectors of the Dane County Department of Planning & Development to determine compliance with the county's zoning ordinances.This consent is valid for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of corn li ce or until earlier revoked in writing by the owngr—of the property. Owner&Agent hereby agree to comply with all Dane un SIGNAT ;E:.>. er/Agen DATE: ` Ordinances.Any unauthorized change from the inform n or plans submitted will invalidate the permit � � Mak& de - ' OFFICE USE ONLY `SURVEY REQUIRED? DATE ISSUED INITIALS 1st I1 DA . NITI�LSS c9 X Yes No 08 Jul 2009 HJH3 7 • © S�{'�/L° ii.„ / DATE REVIE INITIALS 2n SPECTI(O�DAT ■ NI LAS,{v y nitla s: 74. 717-. O / PietV / 1 / l tY "\°v 'C`0l1ditions 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT 'd--1,j REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE� ANY 11� MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIAL •1 2. EROSION CONTROL: OWNER/AGENT MUST CONTACT THE DANE COUNTY DEPARTMENT OF LAND&WATER RESOURCES (608-224-3647)TO HAVE IT DETERMINED IF AN EROSION CONTROL PERMIT IS REQUIRED. 545-112(12/05) GCS-multi