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Application Number:WEB-32319 • DANE COUNTY ZONING PERMIT ZONING PERMIT NO. ZP20090050 OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE VINCENT BREUNIG (608)643-3669 DANIEL KIPPLEY (608)643-4639 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 8232 JADE 8160 LUETH (City,State,Zip) (City,State,Zip) LODI,WI 53555 SAUK CITY,WI -5358 E-MAIL ADDRESS E-MAIL ADDRESS DAN @KIPCC.COM PARCEL NO TOWNSHIP SECTION 1/4 1/4 1/4 0907-024-0567-6 ROXBURY 02 SE NE •a:Tel J 4:t CEA•1•1:l**SI/HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject 8232 JADE DR to field verification.) LOT BLOCK C.S.M.NO.Qr PLAT NAME 7 PLAT: CRYSTAL LAKE ESTATES ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New RI Addition/Alteration CENSUS CODE R-1 .536 Description:GREAT ROOM/FAMILY ROOM/GAR ADDN 434 - RES ADD CATEGORY ;I Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. CI Other: GREAT ROOM/FAMILY ROOM/GAR ADDN ❑Public X Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION E ❑Yes ❑No SHORELAND FLOOD ZONE �1 WETLAND EC/SW NO. ,I)Yes ❑No ❑Yes )4 No ❑Yes X No DINAP-NO HEIGHT(In Feet) BASEMENT lit FLOOR TOTAL SQUARE FEET 1160 12 Sq.Ft. 484 Sq.Ft. 676 PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 82,000.00 O 0 PERMIT FEE 1 Sq.Ft. Sq.Ft. $ 137.00 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. is consent is valid for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of complian or until earli r r yoked in writing by the owner of the property. Owner&Agent hereby agree to comply with all Dane County SIGN : Owner/A nt , DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit :a�i 2-4"7 OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS A Yes o 27 Feb 2009 HJH3 DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: `1.THIS APPROVAL BY DANE COUNTY ZONING I 0 LY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE Conditions.' PROJECT Rr 0 UI-..THE EXPRESS WR • 1 APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF AN s1' ATIONS A- •1 WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. INITIALS , 2. SURV:Y REQUIREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH ZONING ORDINANCE SETBACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND SURVEYOR, AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE FOUNDATION/ o 545-112'112/05) GCS-single •