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il <br /> ZONING PERMIT NO. <br /> DANE COUNTY ZONING PERMIT Page 1 of 2 ZP20090531 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> 7WNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JAMES HAGSTROM (608)831-4422 HART DENOBLE BUILDERS (608)831-4422 <br /> BII.LINGADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 4700 BURGAMOT WAY 7923 AIRPORT RD., <br /> (City,State,Zip) (City,State,Zip) <br /> MIDDLETON, WI 53562 MIDDLETON, WI 53562 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JFRANZEN @DENOBLEBUILDERS.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0808-303-9085-0 SPRINGFIELD 30 SW SW <br /> J:Z•1,4:i iM1,11,1:44:VINI HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 7876 AUTUMN POND TRL <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.Q PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 12670 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: 6 New ❑Addition/Alteration CENSUS CODE <br /> RH-3 14.969 <br /> Description:SFR W!PORCHES&DECKS 101 - SFR <br /> CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> LI Other:SFR W/PORCHES & DECKS ❑Public Private 520382 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E 10015 <br /> ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes No ❑Yes No CI Yes No 20090190 <br /> HEIGHT(In Feet) BASEMENT 7�1 FLOOR TOTAL SQUARE FEET <br /> 25 2902 5413 10546 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3r FLOOR 1,000,000.00 <br /> $ <br /> 2 2231 PERMIT FEE <br /> Sq.Ft. Sq.Ft. 841.00 <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 /> CI Yes1 No 24 Aug 2009 SCW1 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <br /> Conditions: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT <br /> REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF ANY <br /> MODIFICATIONS E WITHOU THE EX ESS WRITTEN P OVAL OF DAN COUNTY ZONING.INITIALS <br /> /�/' n9 C' P !f��ic� r ev e�-� <br /> 2. SURVEY A V SORY NOTE: A LOCATION SURVEY MAY BE REQUIRED / <br /> QUIRED TO VERIFY THAT THE <br /> BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. <br /> 545.112(12/05) GCS-multi <br />