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Ap.Iication Number:APP-36588 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO <br /> d ZP20090506 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> KEITH MALLDER (608)333-2360 TCD BUILDERS (608)212-6934 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 966 STONEHAVEN DR 2851 COUNTRY DR., <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE,WI 53590 SUN PRAIRIE,WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> RANDYMARTEN @WILDBLUE.NET <br /> PARCEL NO. TOWNSHIP SECTION '/4 1/4 1/4 <br /> 0911-183-4033-0 BRISTOL 18 SW SW <br /> -j:1. :A4:iC/t1•l•1:14 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 3161 LORRABUD LN <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 43 PLAT: WINFIELD ESTATES KALLAND ADDN <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: 2I New ❑Addition/Alteration CENSUS CODE <br /> A-1 0.758 Description:SFR W/16'X 14'OPEN DECK&COV FRT POR 101 - SFR <br /> CATEGORY Xi Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: _ ❑Public 1)Private 520373 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND �t EC/SW NO. <br /> X Yes ❑No CI Yes MI No ❑Yes p/No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 4631 <br /> 23 2900 <br /> Sq.Ft. 1731 Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 209,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 397.00 <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 SIG TURE: Owner/A•ent DATE: <br /> Ordinances.Any unauthorized change from the information / l �,/ <br /> or plans submitted will invalidate the permit -t 1 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPE TION DA E INIl4S,, <br /> ❑Yes ❑No 14 Aug 2009 RLB 2-t//jjj0 7[ F—t�1> <br /> DATE REVIEWED INITIALS 2nd 17 E l iO 7b INITI S <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 VOlq ANY <br /> MODIFICATIONS 7 5 R)M¢ , WITHOUT THEE SS WRITTEN APPRIOVAL OFp�A,/Ca TY ZONING.INITIAL/ f/{/� <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(12105) GC single nc,- 1 <br />