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Ape libation Number:APP-34437 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> , ZP20090252 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> M&I MARSHALL & ILSLEY BANK (608)244-4721 TIM PERRY (608)235-0224 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 180 N EXECUTIVE DR 1925 WINNEBAGO ST <br /> (City,State,Zip) (City,State,Zip) <br /> BROOKFIELD,WI 53005 MADISON,WI 53704 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> TPERRY @OPERATIONFRESHSTART.ORG TPERRY @OPERATIONFREASHSTART.ORG <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0710-051-2934-0 BLOOMING GROVE 05 NE NW <br /> IN a:Pia AWILID1 11:I4 1111HOUSENO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 324 POWERS AVE <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 15 7 PLAT: GALLAGHER, ELISHA L PLAT-1ST ADDITION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: W New ❑Addition/Alteration CENSUS CODE <br /> R-3 .12 Description:SFR WITH FRONT PORCH 10 1 - SFR <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: W Public ❑Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> D ❑Yes ❑No <br /> SHORELAND FLOOD ZONE � WETLAND EC/SW NO. <br /> �y1► <br /> ❑Yes )4 No ❑Yes ,1�I No ❑Yes ,)4 No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 2064 <br /> 20 960 1104 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR Ill FLOOR $ 73,425.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 205.00 <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: 0 - •gent DATE: <br /> Ordinances.Any unauthorized change from the information _- <br /> or plans submitted will invalidate the permit 5-ZE(437 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> A Yes ❑No 28 May 2009 SSA1 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: / <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE <br /> Conditions. PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND <br /> VOID IF AN FICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS <br /> 2. SURVEY REQUIREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH <br /> ZONING ORDINANCE SETBACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND <br /> SURVEYOR,AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE FOUNDATION/ • <br /> 545-112(12/05) GCS-single <br /> 6/4 CM-''. ''''4:4•^0/Cd./tut/1,)•--- arezii ij"70. Q L--eiAio,,s r, ,0 IT)ey't -V i-'1"-)Y /4 te C/4°1 a k <br /> // o-- Co <br /> l/-� o k-5 e cz fe.c <br />