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Q. <br /> Ap•lication Number:APP-33548 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090149 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> CLIFFORD RECKER (608)831-5787 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 7240 CLOVER HILL DR <br /> (City,State,Zap) (City,State,Zip) <br /> WAUNAKEE,WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0808-164-6130-0 SPRINGFIELD 16 SE SE <br /> ]:lel J 4 A r-/11 r]el;I 441411111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 7240 CLOVER HILL DR <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 10280 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: 21 New ❑Addition/Alteration CENSUS CODE <br /> R-1 3.7 Description:PERGOLA20X10 329 - OTHER <br /> CATEGORY X Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other.PERGOLA 20X10 ❑Public )I Private NA <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E ❑Yes ❑No <br /> SHORELAND �l FLOOD ZONE �1 WETLAND EC/SW NO. <br /> ❑Yes X No ❑Yes Xal No ❑Yes X No <br /> HEIGHT(In Feet) BASEMENT 1d FLOOR TOTAL SQUARE FEET <br /> 8.75 150 150 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR FLOOR $ 8,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 62.00 <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 w NATURE: Owner/• ,e •TE: <br /> Ordinances.Any unauthorized change from the information /4111";7 , t �� J <br /> 3� <br /> or plans submitted will invalidate the permit /1 <br /> OFFICt USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes A No 21 Apr 2009 HJH3 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> s <br /> 1. OVA DN COUNTY O ONLY DH AE S NO <br /> Conditions. PROJECT THIS APPR REQUIRES L BY THE A EXPRESS WRITTEN ZNING AP IS PROVAL FOR BY T DANE E PL COUNTY PRESE ZONING.TED.THIS ANY PERMIT MODIFICATI SHALL N BE TO NULL THE AND <br /> VOID IF ANY JyIQDIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> 2.THIS PERMIT CORRECTS A VIOLATION OF FAILURE TO OBTAIN A ZONING PERMIT. HJH <br /> 545-112(12/05) GCS-single I <br /> s j (O <br /> 0I — 1 406. C COMp/t& <br />