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• pwiewr 200701-16e Ape libation Number:APP-32808 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090074 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MICHAEL F SIMON BUILDERS INC (608)849-5916 BRIAN HAPP (608)849-5916 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 817 S DIVISION ST 343 RUTH DRIVE <br /> (City,State,Zip) (City,State,Zip) <br /> WAUNAKEE,WI 53597 JEFFERSON, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> TD @SIMONBUILDS.COM <br /> PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-092-2589-0 MIDDLETON 09 NW Nw <br /> Li:t']:4:i 1"/A ol 4] HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (A ssignment of new address is subject 4515 DEERING TRL <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 9 PLAT: FIELDSTONE ESTATES <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New RI Addition/Alteration CENSUS CODE <br /> A-1 .91 Description:DECK 48'X16' 101 - SFR <br /> CATEGORY X Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: ❑Public Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> CI Yes Yes p,t No ❑Yes X No ❑Yes X No • <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 9 688 <br /> 688 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 10,000.00 <br /> PERMIT FEE <br /> 0 Sq.Ft. Sq.Ft. $ 102.00 <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 SI AT R : Own:r/Agent DATE: <br /> Ordinances.Any unauthorized change from the information - <br /> or plans submitted will invalidate the permit rim 4111 <br /> - OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS‘r 1st INSPECT F1,1 ATE INIT LS <br /> CI Yes o 20 Mar 2009 SSA1 <br /> DATE IEW INITIALS 2nd INSPECKIN E INITIALS <br /> Initials: D ��j�10 ` �✓���� C7`� <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 AN47MtFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS <br /> 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE <br /> BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. <br /> 545-112(12/05) GCS-single <br />