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Application Number:WEB-34130 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> + ZP20090270 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> RICHARD URBANOWICZ (608)884-4071 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 2055 RIVIRIE LN <br /> (City,State,Zip) (City,State,Zip) <br /> EDGERTON,WI 53534 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> RV.URB @LITEWIRE.NET <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0511-353-9035-2 DUNKIRK 35 SW SW <br /> a:Js1 J 4 11-/11 DI DI:I* HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 2055 RIVIRIE LN <br /> LOT BLOCK C.S.M.NO.gr PLAT NAME <br /> METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New XI Addition/Alteration CENSUS CODE <br /> R-2 5.09 Description:29'X30'ADDITION TO GARAGE 438 - GARAGE <br /> CATEGORY X Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: 29'X30'ADDITION TO GARAGE ❑Public $1 Private NA <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes ❑No <br /> SHORELAND �t FLOOD ZONE WETLAND EC/SW NO. <br /> 121 Yes Yes No ❑Yes X1 No ❑Yes X No NA <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 6 0 870 870 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 18,000.00 <br /> O O PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 115.00 <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 ;GNATURE: Owner/.gent / DATE: <br /> Ordinances.Any unauthorized change from the information ) ,S--..7-0 <br /> or plans submitted will invalidate the permit , . 'l 1.� r <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPEC ON DATE INITIA <br /> ❑Yes ;441 No 03 Jun 2009 HJH3 'O U <br /> kill DATE REVI WED INITIA 2nd INS E TION ATE INITIALS <br /> Initials: 'N v' 6 /510, 1 Ss <br /> 1.THIS APPROVAL BY DAN COU�TY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION O CATION TO THE <br /> Conditions: PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND <br /> CODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> 545-112(12/05) GCS-single <br />