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Ap.Iication Number:APP-34016 <br /> - DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090206 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> GREGORY DERKSEN (608)509-8211 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 7344 SPRINGHELT DR <br /> (City,State,Zip) (City,State,Zp) <br /> DANE,WI 53529 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> GDDERKSEN @HOTMAIL.COM <br /> PARCEL NO. TOWNSHIP SECTION y4 '/4 1/4 <br /> 0808-043-2067-4 SPRINGFIELD 04 SW Nw <br /> :t•1 J4 it iV/1'1'1 1*IA.HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 7344 SPRINGHELT D R <br /> LOT BLOCK C.S.M.NO.a PLAT NAME <br /> 7 PLAT: SPRINGHELT PLAT <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: RI New ❑Addition/Alteration CENSUS CODE <br /> R-1 1.88 Deschption:40'X 30'X 15.67' DET RES GAR 438 - GARAGE <br /> CATEGORY X Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> CI Other:40'X 30'X 15.67' DET RES GAR ❑Public )I Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E 4455 ❑Yes ❑No <br /> SHORELAND FLOOD ZONE �y{ WETLAND EC/SW NO. <br /> X Yes ❑No ❑Yes X No Lives X No <br /> HEIGHT(In Feet) BASEMENT let FLOOR TOTAL SQUARE FEET <br /> 15.67 1200 1200 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 25,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 140.00 <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: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information / <br /> or plans submitted will invalidate the permit 51/3/c79 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes )I No 12 May 2009 RLB <br /> 6.)—b 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 ANY MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS 0 <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 /> 545112(12/05) GCS-singl lE10cl /•o 5 7�./ 7 /AV r VjvIt ,e <br /> /110c1-1,ks cbilot <br />