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Application Number: WEB-33232 <br /> DANE COUNTY ZONING PERMIT Page 1 of ZONING PERMIT NO. <br /> ZP20090160 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JASON SCHULZ (608)575-8999 BLATTERMAN HOMES (608)819-0300 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 1871 SAND HILL 3460 MEIER RD <br /> (City,State,Zip) (City,State,Zip) <br /> OREGON,WI 53575 MADISON,WI 53718 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> KLARSENAULTI @YAHOO.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0610-304-9910-0 DUNN 30 SE SE <br /> • :('1 J 4 a i-/_1 r]r]:7*Till HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 1871 SAND HILL RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 11046 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: 6 New ❑Addition/Alteration CENSUS CODE <br /> R-IA 1.24 Description:SINGLE FAMILY HOME 101 - SFR <br /> CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> El Other: El Public 'Private 518263 <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 L3 Yes No ❑Yes 17§No <br /> HEIGHT(In Feet) BASEMENT jf FLOOR TOTAL SQUARE FEET <br /> 18 1869 2979 4848 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 311 FLOOR $ 200,000.00 <br /> 1 0 0 PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 414.00 <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 8,Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information <br /> or plans submitted will invalidate the permit /•It 112MA ..._/ T 'a?-C�� <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION TE� INITTS. p <br /> ❑Yes XI No 27 Apr 2009 SSAI 7�2 6 �y}V��\ <br /> DATE REVIEWED INITIALS 2nd INS TIO INITIAL <br /> Initials: ,ij 1i J' <br /> Conditions: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENT D. Y MODIFICATION TO THE PROJECT <br /> REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PE MIT SHALL BE NULL AND V p IF ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS t/ir <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-multi <br />