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• ( Ap.Iication Number:APP-35710 <br /> DANE COUNTY ZONING P ; RMIT \v\ ZONING PERMIT NO. <br /> ZP20090413 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DONS MOBILE MANOR INC (608)831 •869 DAN KERSHNER (608)381-0130 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 5435 KALESEY CT 22445 CTH SR <br /> (City,State,Zip) (City,State,Zip) <br /> WAUNAKEE,WI 53597 RICHLAND CENTER, WI 53581 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. i TOWNSHIP SECTION 1/4 1/s 1/4 <br /> 0808-224-8160-9 SPRINGFIELD 22 SE NE <br /> J a.];I II'MA•l•l:4*1 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 5441 KALESEY CT <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: gl New ❑Addition/Alteration CENSUS CODE <br /> R-4 7.5 Description:SFR W/DECK 101 — SFR <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other:SFR W/DECK ❑Public 14 Private SHARED <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> A ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WE—LAND EC/SW NO. <br /> ['Yes A No ❑Yes X No ❑Yes X No NA <br /> HEIGHT(In Feet) BASEMENT isi FLOOR TOTAL SQUARE FEET <br /> 10 1396 1396 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 20,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 155.00 <br /> 1. I,the undersigned,hereby make application for a zoning perm t 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= 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 •rovision 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 o'Icial map to the applicants'land; <br /> • No such official map is applicable,or,if such map is appli ..le,the approval of the appropriate city or village has been obtained; <br /> • I have not relied upon any statements of County employee-in giving these assurances; <br /> • I understand the possible adverse consequences of erectin• 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 lo :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 oid. <br /> 3. I, the undersigned, hereby consent to the entry on the pe itted premises by zoning inspectors of the Dane County Department of Planning & <br /> Development to determine compliance with the county's zoni g ordinances.This consent is valid for the period commencing with issuance of this <br /> zoning permit and terminating with issuance of a certifica e of compliance or until earlier revoked in writing by the o er,Tof the property. <br /> Owner&Agent hereby agree to comply with all Dane Con GNATU RE: Owner/A.- t + w "`7 E <br /> Ordinances.Any unauthorized change from the informal i.n r / , <br /> or plans submitted will invalidate the permit // �• ' f 5 O <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes A No 15 Jul 2009 HJH3 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> iK <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE-ROJECT <br /> Conditions: REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BEN . <br /> ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONI. 1 a <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 /`� ^1Q04: 1<k <br />