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Ap•Iication Number:APP-32659 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090063 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MARC STUDER (608)839-1725 SAME AS OWNER RECEIVED <br /> `®BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) R , <br /> 4454 BAXTER RD <br /> (City,State,Zip) (City,State,Zip) <br /> COTTAGE GROVE, WI 53527 MAR 2 0 2009 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> KIMOKITA @VERIZON.COM <br /> PARCEL NO. I TOWNSHIP 3E LANIIING rEVW rr '7` <br /> 0711-112-8700-5 COTTAGE GROVE DANECOt�t ' NW <br /> 1M J(•1 a I:I r�/d'1 DI:I*-1-1111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 4454 <br /> to field verification.) BAXTER RD <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 02340 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New Iid Addition/Alteration CENSUS CODE <br /> R-1 .785 Description:3 SEASON PORCH 10 X 24 434 - RES ADD <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other:3 SEASON PORCH 10 X 24 ❑Public gI Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C Oyes ❑No <br /> SHORELAND FLOOD ZONE �,1 WETLAND EC/SW NO. <br /> CI Yes Yes pl No ❑Yes X No ❑Yes XI No <br /> HEIGHT(In Feet) BASEMENT 1,st FLOOR TOTAL SQUARE FEET <br /> 12 240 240 <br /> Sq.Ft. Sq.Ft. _ PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 360.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 68.00 <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 withi official mapped area for hich the app'cant has no obtained the proper <br /> permit from the appropriate village or city shall be null and void. withi <br /> S D 1` el .0 t C-_k7' A h f< ._—t �-.j <br /> 3. I, the undersigned, hereby consent to the entry on the permitted premises by zrning inspectors of the Dane County Department of PlanniAg & <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 8 Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: <br /> Onfinances.Any unauthorized change from the information 14( <br /> or plans submitted will invalidate the permit y^,(�j � ��� !/ <br /> '1 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPEC ION DAT INITIALS <br /> ❑Yes I No 16 Mar 2009 CHS1 j 23/D <br /> (fin DATE REVIEWED INITIALS 2nd Its ECSI�DgT� INIT <br /> Initials: r r< < cJ t l// /// <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE <br /> Conditions: PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND <br /> VOID IF ANY MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS IA.5 r <br /> 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE <br /> BUILD! G S CON TRUCTED CCORDING TO THE PLAN SUBMITTED IT THIS APPLICATION. <br /> r, k cetw&v ( C IT ,A90 - <br /> 545-112(12/05) GCS-single C S i�� h vt / /r <br /> /DVS � ' 0�' A. 0 i, iPi. <br />