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Ap•lication Number:APP-34193 ' ZONING PERMIT NO. -DANE COUNTY ZONING PERMIT ZP20090229 OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE LINDA JONES (608)437-7219 TOM REECE (608)698-8968 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 1809 SYVRUD RD 8426 ELDERBERRY ROAD (City,State,Zip) (City,State,Zip) MT HOREB,WI 53572 MADISON,WI 53717 E-MAIL ADDRESS E-MAIL ADDRESS TREECE @SACW.COM PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0606-344-8501-9 BLUE MOUNDS 34 SE NW •Ja•]»:ith 'l']d 44z-all HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME CERTIFIED SURVEY MAP: CSM 03905 ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: tki New ❑Addition/Alteration CENSUS CODE CO-1 .23 Description:165'CELL TOWER AND 12'X 27'BOX 329 - OTHER CATEGORY ❑Residential g Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other: 165'CELL TOWER AND 12'X 27' BOX ❑Public )iej Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION A 10007 2098 ❑Yes ❑No SHORELAND FLOOD ZONE �{ WETLAND EC/SW NO. �l ❑Yes ,nl No ❑Yes A No ❑Yes X No HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 165 311 311 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR kr FLOOR $ 18,000.00 PERMIT FEE 0 Sq.Ft. Sq.Ft. $ 236.00 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 complian - or until earlier revoked in writing by the owner of the property. Owner&Agent here by agree to comply with all Dane County SIGN• URE: Owner/Agent DATE: Ordinances.Any unauthorized change from the information i /Ji A, J ��, or plans submitted will invalidate the permit `� OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED ' INITIALS 1st INSPECTION DA E INITIALS II ❑Y X No 19 May 2009 pmk2 s 'N ''D s 0 tttt MM '/I DATE REV I INITIA�S 2nd INSPECT... DATA` /0 S INI�ALS� Imo. �/N// NC O'(l S / (() 1.THIS APPROVAL BY DANE UN ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE Condit ions: PROJECT Q JRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF - ,/ '••IFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. INIT ° :,l� RVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE ILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLIcATIOrp 545-112(12/05) GCS-single ` 1 l� "F `�Jl 't „Y v \ b �` . � o s��,�1_ - up -