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DANE COUNTY ZONING PERMIT Page 1 of 2 ZONING PERMIT NO. ZP20090577 OWNER INFORMATION AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE RANDY KLOCK (608)241-4248 SAME AS OWNER (608)209-3688 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 3161 COUNTY HIGHWAY T (City,State,Zip) (City,State,Zip) SUN PRAIRIE, WI 53590 E-MAILADDRESS E-MAILADDRESS PARCEL NO. TOWNSHIP SECTION 1/4 1/4 y4 0811-313-8730-4 SUN PRAIRIE 31 SW NW 1/1 JI:Is]:2 1AIWA NI D]:1 441111 HOUSE NO. ST.DIRECTION STREET NAME ST TYPE (Assignment of new address is subject 3161 COUNTY HIGHWAY T to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME METES SAND BOUNDS: METES AND BOUNDS ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT ❑New tJ Addition/Alteration CENSUS CODE A-1 EX 5 Description:GARAGE ADDN 434 - RES ADD CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑other: GARAGE ADDN ❑ Public 1,�, TJ Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO VARIANCE NO. DEED RESTRICTION B ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑Yes No ❑Yes 'L]No ❑Yes No HEIGHT(In Feet) BASEMENT 1aj FLOOR TOTAL SQUARE FEET g 220 220 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 1,200.00 1 PERMIT FEE Sq.Ft. Sq.Ft. $ 134.00 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 SIGNAT -E: Ow/-er/Agent DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit / OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS Yes ❑ No 14 Sep 2009 SCW1 ^� DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS U/i1l Initials: Conditions: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF Y MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS v.,. ��i 2.SURVEY REQUIREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH ZONING ORDINANCE SET:ACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND SURVEYOR,AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE FOUNDATION/BASEMENT WALLS ARE COMPLETED,OR IF THE PROJECT DOES NOT INCLUDE FOUNDATION/BASEMENT WALLS,AT THE TIME THE LOCATION OF THE STRUCTURE IS ESTABLISHED,AND BEFORE ANY OTHER WORK IS DONE. 545-112(12/05) GCS-multi