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• ' Application Number: WEB-33314 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090115 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> HELEN EVERSON (608)884-3367 ANDRE JONES (608)207-3330 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 114 KELLOG 1552 SUMMIT <br /> (City,State,Zip) (City,State,Zip) <br /> EDGERTON, WI 53534 BELOIT, 53511 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ANDREJONES @MIDWESTGARAGEBUILDERS.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0512-121-9000-1 ALBION 12 NE SW <br /> •a:Z•l J 4:i 1 M 1'1'1:1#,f M HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 114 KELLOGG RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.Qr PLAT NAME <br /> METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: I New Cl Addition/Alteration CENSUS CODE <br /> A-2 40 Description:BUILD GARAGE(24X34) 438 - GARAGE <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: 24 X 34 GARAGE ❑Public 14 Private PRIVATE <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes No ❑Yes No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 816 <br /> 12 0 816 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR Cdr FLOOR ,$ 16,000.00 <br /> 0 0 PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. 111.00 <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 ' writing by the owner of the property. <br /> Owner 8,Agent hereby agree to comply with all Dane County SI NATURE: • ner/A• ,� 1 DATE: <br /> Ordinances.Any unauthorized change from the information L J 9 n <br /> or plans submitted will invalidate the permit �1 J / .� • d 7 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS t IN ION ATE INITIALS <br /> ❑Yes No 09 Apr 2009 SCW1 / 17 co r, / <br /> n DATE REVIEWED INITIALS 2nd INS ECTIddN p TE INITIAIAAL.S - <br /> _ <br /> l 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 M D,IFICATIONS 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 />