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• Application Number:APP-36528 ZONING PERMIT NO. DANE COUNTY ZONING PERMIT Page 1 of 2 ZP20090496 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE MARK JUCKETT (608)644-8813 FREY CONSTRUCTION AND HOMEd (608)643-7914 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 6850 TAYLOR RD 530 PARK AVE., (City,State,Zip) (City,State,Zip) SAUK CITY,WI 53583 PRAIRIE DU SAC,WI 53578 E-MAIL ADDRESS E-MAIL ADDRESS PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0907-302-9591-1 ROXBURY 30 NW SE a'1»:1 11'/d'l•l:4 441N HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject 6850 TAYLOR RD to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 1 CERTIFIED SURVEY MAP: CSM 08676 ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: CI New ZS]Addition/Alteration CENSUS CODE RH-2 6 Description:SCREENED PORCH ADDN 434 - RES ADD CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other:SCREENED PORCH ADDN ❑Public Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION C ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑Yes No ❑Yes No ❑Yes No HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 11 255 255 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 25,000.00 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 compliance or until earlier revoked in writing by the owner of the property. Owner&Agent hereby agree to comply with all Dane County SIGNATUIg Own nt DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit I 4(00' OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPE TIQNT i AT INIT ❑Yes XI No 12 Aug 2009 SCW1 DATE REVIEWED INITIALS 2nd INSPEC ION NAT INITIALS Initials: ' tO goo Conditions: 1.T IS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. AN MODIFICATION TO THE PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF ANY MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS 2. EROSION CONTROL: OWNER/AGENT MUST CONTACT THE DANE COUNTY DEPARTMENT OF LAND&WATER RESOURCES(608-224-3647) H VE IT D TERMINED IF AN EROSION CONTROL PERMIT IS REQUIRED. SIGNATURE �,,,..G.•.� (J� DATE a 4146-- ©�1 545-112(12/05) GCS-multi `