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Application Number:APP-34113 <br /> ZONING PERMIT NO. <br /> DANE COUNTY ZONING PERMIT Page 1 oft ZP20090218 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> KEITEL PROPERTIES LLC (608)244-1146 LUNDGREN'S BRUSH (608)358-3894 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 3880 STEVEN DR 2182 CTH MM <br /> (City,State,Zip) (City,State,Zip) <br /> DEFOREST, WI 53552-2982 OREGON,WI 53575 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> BOB @LUNDRENSBRUSH.COM <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0810-032-1596-0 BURKE 03 NW NE <br /> :1•111 11:i #4:11/HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 3880 STEVEN DR <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.Q PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 09638 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: 61 New ❑Addition/Alteration CENSUS CODE <br /> B-1 .793 Description:PYLON SIGN ON PREM AD <br /> CATEGORY ❑Residential )Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑other:PYLON SIGN ON PREM AD ❑Public ❑Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes No ❑Yes No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT if FLOOR TOTAL SQUARE FEET <br /> 15.5 32 32 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ <br /> PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 100.00 <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&Agent hereby agree to comply with all Dane County SIGNATU-A: •wner/ genes DATE: <br /> Ordinances.Any unauthorized change from the information -- S rg- O <br /> or plans submitted will invalidate the permit I a l <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS � INSPECTION DATE INN ALS <br /> Yes ❑No 15 May 2009 HJH3 L- <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: i\� AL— <br /> Conditions: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT <br /> REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VO IF ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS L- <br /> 2.SURVEY REQUIREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH ZONING ORDINANCE SETBACKS. THE <br /> SURVEY SHALL BE PREPARED BY A REGISTERED LAND SURVEYOR,AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE <br /> FOUNDATION/BASEMENT WALLS ARE COMPLETED,OR IF THE PROJECT DOES NOT INCLUDE FOUNDATION/BASEMENT WALLS,AT THE TIME <br /> THE LOCATION OF THE STRUCTURE IS ESTABLISHED,AND BEFORE ANY OTHER WORK IS DONE. � I JJ <br /> 545-112(12/05) GCS-multi / / 0\ — looks j � J`tJr'�u r.�y <br />