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Ap•Iication Number:APP-34136 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090223 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> RONALD NELSON (608)873-6460 DAVID A NELSON (608)358-2771 <br /> BILLING ADDRESS (Number,Street) I ADDRESS (Number,Street) <br /> 3264 RUTLAND-DUNN TOWNLIN 3339 RUTLAND DUN ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON,WI 53589 STOUGHTON,WI 53589 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> NELLIE425 @LITEWIRE.NET <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0610-364-9000-0 DUNN 36 SE SW <br /> J('1 J I 1/_101 D1:1*TAM HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) <br /> 3264 RUTLAND-DUNN TOWN LINE RD <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> "METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New 14 Addition/Alteration CENSUS CODE <br /> A-1 EX 80.0 Description:GARAGE ADDITION 434 - RES ADD <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: Li Public Private 518281 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes 0 N <br /> SHORELAND FLOOD ZONE y� WEiTLAND EC/SW NO. <br /> ❑Yes X No ❑Yes X No ❑Yes X No <br /> HEIGHT(In Feet) BASEMENT iat FLOOR TOTAL SQUARE FEET <br /> 10.25 480 480 <br /> Sq.Ft. I Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR and FLOOR $ 62,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 86.00 <br /> I <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,on 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 zo ng 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 /> U <br /> Owner&Agent hereby agree to comply with all Dane Co my SIGNATURE: Owner/Agent DATE: <br /> Oniinances.Any unauthorized change from the information / S g 0 <br /> or plans submitted will invalidate the permit / _ ii 5 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION D E INITIA <br /> ®Yes ❑No 18 May 2009 SSA1 8 Z J O 7 <br /> DATE REVIEWED INITIALS 2nd IN412 TION TE INITIALS <br /> Initials: i- 1. 9 v Y'V <br /> I ` <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 Amy M9pIFICATIONS ARE MADE WI—HOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS • /5- <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(12/05) GCS-single <br />