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• <br /> • Ap•lication Number:APP-34121 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20090220 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> MARK LOHR (608)320-0135 DESIGN BUILDERS LLC (608)444-7965 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 1901 N PAGE ST 2242 HWY AB <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON,WI 53589 MCFARLAND, WI 53558 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0610-361-0775-5 DUNN 36 NE NE <br /> J:Z•191 I E A 1111:7 41-1111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 3178 DUNCAN RD <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 15 1 PLAT: COUNTRY CLUB PARK <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New 14 Addition/Alteration CENSUS CODE <br /> R-3 .50 Descnption:GARAGE ADDITION 434 - RES ADD <br /> CATEGORY ;ICI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: ❑Public ❑Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes ❑No ❑Yes ❑No ❑Yes ❑No <br /> HEIGHT(In Feet) BASEMENT lit FLOOR TOTAL SQUARE FEET <br /> 35 325 1359 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR rd FLOOR $ 125,000.00 <br /> 1034 PERMIT FEE <br /> 2 Sq.Ft. Sq.Ft. $ 127.00 <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!'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 SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the infonnatiorr - A <br /> or plans submitted will invalidate the permit 1` `g C <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSP CTIQapATE INITIALS <br /> Yes ❑No 18 May 2009 SSA1 12 I� t <br /> DATE REVIEWED INITIALS 2n P CTI D E INITIALS <br /> Initials: � 'loe <br /> Z <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS RESE TED. 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 MO IFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALSA <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/ 0 <br /> 545-112(12/05) GCS-single <br />