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Abdication Number:APP-36845 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090530 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MICHAEL SUSSMAN (608)475-2003 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 8761 HIDDEN VALLEY RD <br /> (City,State,Zip) (City,State,Zip) <br /> CROSS PLAINS,WI 53528 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. I TO'N''Sr IP SECTION 1/s 1/4 1/4 <br /> 0707-161-9590-7 ,D t9 'y -OS P AINS 16 NE SE <br /> MI;A ['Ia4:ii1"/d•Iil:I=E*11111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 8761 HIDDEN VALLEY RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> CERTIFIED SURVEY MAP: CSM 03899 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: XI New ❑Addition/Alteration CENSUS CODE <br /> 4::, A-1 EX 20 Description:AGRICULTURAL ACCESSORY BUILDING 329 - OTHER <br /> �� CATEGORY ❑Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other:30X60 AGRICULTURAL BUILDING ❑Public XI Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E ❑ pll <br /> ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND �{ EC/SW NO. <br /> ❑Yes )4 No Yes A No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 0 1800 <br /> 15 1800 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ <br /> ',<....(:)..... PERMIT FEE <br /> � Sq.Ft. Sq.Ft. $ 185.00 <br /> 3' 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: Own gent DATE: <br /> Ordinances.Any unauthorized change from the information '���/ <br /> or plans submitted will invalidate the permit / , I" <br /> OFFICE USE ONLY <br /> SURVEY' •- 'ED? DATE ISSUED INITIALS 1st INSPECTION D TE INITIALS <br /> ❑YesNo 24 Aug 2009 RWL1 0 <br /> DATE REVIEWED INITIALS 2nd INSPECT! N TEE INITIALS <br /> Initial-W4 4 I Zit C •e-°—(_.) <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 />