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`:; ; ' Dane Qounty Planning & Development <br /> iEr' Room 116,City-County Building, Madison, Wisconsin 53709 Land Division Review <br /> rtu F i-;�1• 608/266-9086 <br /> '`CO$ = property Listing <br /> 608/266-4120 <br /> surveyor <br /> 608/266-4252 <br /> CERTIFICATION OF OFFICIALLY MAPPED AREAS Zoning <br /> 608/266-4266 1O APPLICANT'S LANDS - <br /> The undersigned applicant for a zoning permit under Chapter 10 of the Dane <br /> County Ordinances thus certifies as follows: <br /> 1. That he or she has made diligent inquiry into the applicability of any official <br /> map to the applicant's land. <br /> 2. That no such official map is applicable or, if such map is applicable, the <br /> approval of-the appropriate city or village has been obtained. <br /> 3. That the applicant has not relied upon any statements of County employees in <br /> giving these,assurances. <br /> 4. That the applicant understands the possible adverse consequences of erecting <br /> any structure within an officially mapped area without the proper approval of <br /> the city or village involved. Any zoning permit issued for a property located <br /> within an officially mapped area for which the applicant has not obtained the <br /> proper permit from the appropriate village or city shall be null and void. <br /> (Ref. §10.25 (6(b)and(d)Dane County Zoning Ordinance) <br /> Dated this 3 day of frip,SEE, , 20 02,in Madison Wisconsin. <br /> Signed: /6`3/6Z <br /> Witness: <br /> Zoning Permit# <br /> h:\plandev\zoning\znr\forms.fint\officially mapped areas.doc (Revised 03/00) <br />