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Ap•Iication Number:APP-36900 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090541 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JOSEPH MLSNA (608)437-1010 SAME AS OWNER (608)576-8766 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 9073 COUNTY HIGHWAY S <br /> (City,State,Zip) (City,State,Zip) <br /> MT HOREB,WI 53572 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0607-051-9220-0 SPRINGDALE 05 NE SW <br /> PROPERTY ADDRESS HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 9073 COUNTY HIGHWAY S <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 10351 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New 14 Addition/Alteration CENSUS CODE <br /> A-1 5.098 Description:16'X32'DECK 434 - RES ADD <br /> CATEGORY X Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: 16'X32' DECK ❑Public XI Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B ❑Yes ❑No <br /> SHORELAND 1��tt FLOOD ZONE �yI WETLAND 1�f EC/SW NO. <br /> ❑Yes ,ral No ❑Yes X]I No ❑Yes pl No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 512 512 <br /> 10 Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 4,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 177.00 <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 • • ' earlier revoked in writing by the owner of the property. <br /> Owner 8,Agent hereby agree to comply with all Dane County SIG • ner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information t <br /> or plans submitted will invalidate the permit Z� d <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Y s l No 26 Aug 2009 pmk2 I 0 1 r K <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE ^ INITIALS <br /> 1 <br /> Initials: ^01C 3 ^ 0 9 <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 V0112 W ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS <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(12/05) GCS-single <br />