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1 MIJ 10.:dLIUI I INUI-I WC!./1rr-JUJ4v <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090500 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> 5813 N HIGHWAY 51 LLC (608)249-5633 MADISON BLOCK& STONE (608)249-5633 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 5813 US HIGHWAY 51 5813 US HIGHWAY 51 <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53718 MADISON, WI 53704 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JANDERSON @MADISONBLOCKANDSTONE.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0810-084-9780-2 BURKE 08 SE SE <br /> 1111 :to]4;l 1 100:I 44A111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 5813 U S HIGHWAY 51 <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.9r PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 04139 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: 21 New ❑Addition/Alteration CENSUS CODE <br /> C-2 10.72 Description:22X35X16 3-WALLED SHED 329 - OTHER <br /> CATEGORY ❑Residential Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other:22X35X16 3-WALLED SHED ❑Public $1 Private NA <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND �t EC/SW NO. <br /> ❑Yes X ❑ ,e► <br /> No ❑Yes X No Yes No NA <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 14 770 770 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2n FLOOR 3111 FLOOR $ 0.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 200.00 <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 <br /> or plans submitted will invalidate the permit <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes XI No 13 Aug 2009 HJH3 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT <br /> Conditions: REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS <br /> 545-112(12/05) GCS-single <br />