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Application Number:APP-37359 V DANE COUNTY ZONING PERMIT Page 1 oft ZONING PERMIT NO.ZP20090580 OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE ELIZABETH DUDZIK (847)781-9253 SAME AS OWNER BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 630 ORANGE LN (City,State,Zip) (City,State,Zip) HOFFMAN ESTATES, IL 60169 E-MAIL ADDRESS E-MAIL ADDRESS LIZ @LIZZOCO.COM PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0512-254-2305-7 ALBION 25 SE Nw •J t'1 J 4:i IWd 1111:I 44101 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject 396 LAKE SHORE DR to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 5 2 PLAT: EDGERTON BEACH PARK ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New ❑Addition/Alteration CENSUS CODE R-3 0.27 Description:SFR TO REPLACE FLOOD-DAMAGED HOME 101 - SFR CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other: Public ❑Private NR ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION D -- 3576 ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO. Yes 0 N Yes Li No ❑Yes No REQUIRED HEIGHT(In Feet) BASEMENT 1C FLOOR TOTAL SQUARE FEET 14 0 1340 1340 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 71,000.00 1 0 0 PERMIT FEE Sq.Ft. Sq.Ft. $ 151.00 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 Coun�SIGNATU--. Owner/Agent «i ATE. Ordinances.Any unauthorized change from the information Old //or plans submitted will invalidate the pemmit / % 0 OFFICE USE 3NLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS A Yes ❑No 14 Sep 2009 KLS DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: , 1.U11dtt1011s. 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, NY MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONIN INITIAL 2. EROSION CONTROL: OWNER/AGENT MUST CONTACT THE DANE COUNTY DEPARTMENT OF LAND&WATER RESOURCES.(608-2 7)TO HAV I ET MINED IF AN EROSION CON ROL PERMIT IS REQUIRED. GNATURE �/ tAi (ATE'l 9/'r'/ 7_. 545-112(12/05) GCS-multi