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Mil III:dUUII PAUIIIUCI.Mr-r"-A lo4c <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090027 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DAN HANNAN (715)215-1493 NORTHPOINTE CONST INC 6082194051 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> W8828 JASON DR P 0 BOX 562 <br /> (City,State,Zip) (City,State,Zip) <br /> BEAVER DAM, WI 53916 DEFOREST, WI 53532 <br /> E-MAIL ADDRESS E-MAILADDRESS <br /> APRILWHITE21@YAHOO.COM MIKE @NORHTPOINTECONSTRUCTION.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0911-303-4119-0 BRISTOL 30 SW SW <br /> • - ' • ' • - HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 3132 <br /> to field verification.) KATIE IDA LN <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 69 PLAT: BRISTOL GARDENS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT New ❑Addition/Alteration CENSUS CODE <br /> A-1 .66 Description:SFR 101 — SFR <br /> CATEGORY XI Residential ❑Commercial LI Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other:SFR ❑Public $J Private 518227 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> D ❑Yes ❑No <br /> SHORELAND �y1�t >1 FLOOD ZONE ❑ 1�t WETLAND EC/SW NO. <br /> ❑Yes J� No ❑Yes No Yes No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 23 2288 5614 7902 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES bid FLOOR FLOOR $ 350,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 643.00 :. <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 /> Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information <br /> or plans submitted will invalidate the permit <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> Yes ❑ No 02 Feb 2009 CHS1 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <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 VOID IF ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS <br /> 2. SURVEY REQUIREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH <br /> ZONING ORDINANCE SETBACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND <br /> SURVEYOR, AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE <br /> 545-112(12/05) GCS-single <br />