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• Ap.Iication Number:APP-35392 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090370 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DAVID JASINSKI (608)831-1834 ORIGINALS, INC DBA ARCHADECK o (608)839-1133 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 8555 ELLINGTON WAY 360 PROGRESS DR#106 <br /> (City,State,Zip) (City,State,Zip) <br /> MIDDLETON,WI 53562 COTTAGE GROVE,WI 53527 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> DWJASINKI @HOTMAIL.COM MADISON @ARCHADECK.NET <br /> PARCEL NO. 1 TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0708-051-2023-8 MIDDLETON 05 NE Nw <br /> •J;t.]J 4 a 11W1'1.1:1 441111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 8555 ELLINGTON WAY <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 33 PLAT: STONEBROOK ESTATES <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New gl Addition/Alteration CENSUS CODE <br /> A-1 .51 Description:DECK tiCO &_• 434 - RES ADD <br /> CATEGORY X.1 Residential ❑Commercial ❑Ag' ultural SEWER SANITARY PERMIT NO. <br /> ❑Other: ❑Public XI Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E ID Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> y�I �y{ <br /> . ❑Yes pl No ❑Yes ,r]I No ❑Yes XI No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 352 <br /> 1 352 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR Ird FLOOR $ 26,000.00 <br /> PERMIT FEE <br /> 0 Sq.Ft. Sq.Ft. $ 76.00 <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 SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information <br /> or plans submitted will invalidate the permit / I P.A. 7-- <br /> • <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1 S SPECTION D TE I∎ 'L <br /> ❑Yesl No 02 Jul 2009 SSA1 1 <br /> ,,v..,t/6 DATE REVIEWED INITIALS 2nd INSPECTION , INI I S <br /> Initials: /1 t <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODI ICON T THE <br /> Conditions: PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND <br /> VOID IF AN'4 JDIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS /�{�//J� <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(12105) GCS-single ^ V" �.�-��./ <br /> Z s?A‘Oi 1 tiA, A�/�r 1,� V _ <br /> er <br />