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Apo libation Number:APP-37187 • DANE COUNTY ZONING PERMIT ZONINGPERMITNO OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE RICHARD REINES (608)839-4869 SAME AS OWNER (608)445-0567 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 4686 GASTON CIR (City,State,Zip) (City,State,Zip) COTTAGE GROVE, WI 53527 E-MAILADDRESS E-MAIL ADDRESS 5700GE-3 @HOTMAIL.COM . PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 0711-042-8230-9 COTTAGE GROVE 14 NE PROPERTY ADDRESS et '' `" r a OW STREET A s TYPE (Assignment of new address is sub . c� sf , n 1 ' ` {r; '. to field verification.) :, s. .:. ,4686 r: +';i a, >_s. -:- .,.,i j 0 41i< ,,,. LOT BLOCK C.S.M.NO. PLAT NAME 2 CERTIFIED SURVEY MAP: CSM 01726 ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New ❑Addition/Alteration CENSUS CODE R-1 0.47 Description:22 X 16'X 15'GAR ADDN 438 - GARAGE CATEGORY 1 Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other: ❑Public XI Private 518169 ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION C ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND pl p{ EC/SW NO. ❑Yes 14 No ❑Yes .DI No ❑Yes No HEIGHT(In Feet) BASEMENT ]_s/FLOOR TOTAL SQUARE FEET 15 345 345 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 15,100.00 PERMIT FEE 1 Sq.Ft. Sq.Ft. $ 76.00 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 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 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 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. 2. I,the undersigned,hereby certify that: • I have made a diligent inquiry into the applicability of any official map to the applicants'land; • No such official map is applicable,or,if such map is applicable,the approval of the appropriate city or village has been obtained; • I have not relied upon any statements of County employees in giving these assurances; • I understand the possible adverse consequences of erecting any structure within an officially mapped area without the proper approval of the city or village involved.Any zoning permit issued for a property located within an official mapped area for which the applicant has not obtained the proper permit from the appropriate village or city shall be null and void. 3. I, the undersigned, hereby consent to the entry on the permitted premises by zoning inspectors of the Dane County Department of Planning & Development to determine compliance with the county's zoning ordinances.This consent is valid for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of compliance or until earlier revoked in writing by the owner of the property. Owner&Agent hereby agree to comply with all Dane County SIGNATU+ ' 'tint a '', E .," Ordinances.Any unauthorized change from the information l.i.'44,:: -.1' 4 i °� ' or plans submitted will invalidate the permit x - OFFIOE USE ONLY ,ia� f 7 i5i •e" DATE ISSUED INITIALS 1st INSP TIO DATE INITIALS_ '' ' a ❑No 03 Sep 2009 RLB /(/ /�r /e L-� - DATE REVIEWED INITIALS 2nd INSPEC ION DATE INITIALS -`'1`1 TiIIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT Conditions: REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF ANY MODIFICATIONS A E MADr THOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INIT ALS 1 L$7 ,) & / K. ktItt:C5Q �. 5 - 2- i 22 E9t/S'/ 1 =E _qtr s UiZV� a ° },E Et>. 'IL"O•� e,, S .fi'E� _ S' ,EQU�D ® V GO r , SURv v® ; i I) "�� acR C I'ED.: b •''.4 ._CO'x ...�._ Q v v rr ;pkurraz,� r Z(12/05) GCS- IlG,-..__.. � f- ,r L `�, � t( I 1 / J' i�1