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• <br /> Application Number:APP-31392 <br /> ZONING PERMIT NO. <br /> DANE COUNTY ZONING PERMIT Page 1 of 2 ZP20090016 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> RICHARD MESEBERG (608)873-7118 SAME AS OWNER (608)628-3469 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 1820 HAWKINSON RD <br /> (City,State,Zip) (City,State,Zip) <br /> OREGON,WI 53575 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> MESEBERG @RAYMONDTEAM.COM <br /> PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0610-342-8346-1 DUNN 34 NW NE <br /> M./:tot 14 a C/1110:7*1-11111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (A ssignment o new address is subject 1820 HAWKINSON RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 07409 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New LJ Addition/Alteration CENSUS CODE <br /> RI-1-2 5.53 pescription:60'X128'ADDITION TO POLE BARN 437-NON-RES ADD <br /> CATEGORY F Residential ❑Commercial IlUk Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: <br /> 60'X128'ADDiTION TO POLE BARN ❑Public Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C 5399 ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes No ❑Yes No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT 1 t FLOOR TOTAL SQUARE FEET <br /> 20 7680 7680 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR Ord FLOOR $ 40,000.00 <br /> 1 PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 626.00 <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 /> — <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATU- • O nerlAgent DATE: <br /> Ordinances.Any unauthorized change from the information , <br /> or plans submitted will invalidate the permit , — _2-4y <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st DATE c� INITIAL$ <br /> ❑Yes No 22 Jan 2009 pmk2 7 ZO 07 I [/�J)'P <br /> DATE REVIEWED INITIALS 2nd INSPE c /? IN pr <br /> Initials: c[1 cJ J{I, <br /> CO 11diti ; 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENT . ANY ODIFICATION TO THE PROJECT <br /> REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS <br /> 2. ACCESSORY BUILDING-NO COMMERCIAL: THIS BUILDING SHALL NOT BE <br /> USED FOR ANY BUSINESS OR COMMERCIAL PURPOSE. <br /> 545-112(12/05) GCS-multi <br />