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• 8 ;1f SfitXJ13e,,' Application Number: WEB-34642 DANE COUNTY ZONING PERMIT ZONING PERMIT NO. ZP20090286 OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE TIM VS OF MADISON LLP (608)444-7280 TIMOTHY STRAIGHT (608)575-2801 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 2221 MUSTANG S11960 WILLIAMS ROAD (City,State,Zip) (City,State,Zip) MADISON, WI 53718 SPRING GREEN, WI 53588 E-MAIL ADDRESS E-MAIL ADDRESS TNKSTR8 @HUGHES.NET TNKSTR8 @HUGHES.NET PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0908-241-8120-4 DANE 24 NE NE 1;fel a 4 A 11"/d el 0 N* HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject 7179 STATE HIGHWAY 113 to field verification.) LOT BLOCK C.S.M.NO or PLAT NAME 1 CERTIFIED SURVEY MAP: CSM 07267 ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New lid Addition/Alteration CENSUS CODE R-1 2.0 Descnption:TWO DECK ADDITION TO HOUSE 434 - RES ADD CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. Other: 14 Public ❑Private WI ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION C 5700 ❑Yes ❑No SHORELAND FLOOD ZONE �1 WETLAND EC/SW NO. ❑Yes X No ❑Yes X�I No X Yes ❑No HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 549 0 0 549 Sq.Ft. Sq.Ft. PROJECT COST • NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 4,000.00 0 0 PERMIT FEE 0 Sq.Ft. Sq.Ft. $ 91.00 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 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 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 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. 2. I,the undersigned,hereby certify that: • I have made a diligent inquiry into the applicability of any official map to the applicants'land; • No such official map is applicable,or,if such map is applicable,the approval of the appropriate city or village has been obtained; • I have not relied upon any statements of County employees in giving these assurances; • I understand the possible adverse consequences of erecting any structure within an officially mapped area without the proper approval of the city or village involved.Any zoning permit issued for a property located within an official mapped area for which the applicant has not obtained the proper permit from the appropriate village or city shall be null and void. 3. I, the undersigned, hereby consent to the entry on the permitted premises by zoning inspectors of the Dane County Department of Planning & Development to determine compliance with the county's zoning ordinances. This consent is valid for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of compliance or until earlier revoked in writing by the owner of the property. Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Owner!,.r en DATE: Ordinances.Any unauthorized change from the information — / ' &1139/0 or plans submitted will invalidate the permit I/ Z OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS A Yes ❑No 09 Jun 2009 SSA1 • DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS Initials: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE Conditions: PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF AN •.IFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. INITIALS LI 2. SURVEY RE* IREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH ZONING ORDINANCE SETBACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND SURVEYOR,AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE FOUNDATION/ o 545-112(12/05) GCS-single 711ii/c,c\ 1r>P 1,-J-3. Co-rep1 e L �-��/ k i -1