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Ap•lication Number:APP-33943 • PERMIT ERMIT NO. DANE COUNTY ZONING PERMIT ZP0ERMI OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE BLIMING REV TR, JANET G (608)839-5276 DUANE FARWELL (608)222-1730 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 4417 BUCKLEY RIDGE CIR 3818 COUNTY HIGHWAY AB (City,State,Zip) (City,State,Zip) COTTAGE GROVE, WI 53527 MADISON,WI 53718 E-MAIL ADDRESS E-MAIL ADDRESS FARWELLTECH @HUGHES.NET PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0711-101-4023-0 COTTAGE GROVE 10 NE SW :LW li 4.1 1 r]i]:7*1-1111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject 4417 BUCKLEY RIDGE CIR to field verification.) LOT BLOCK C.S.M.NO.gr PLAT NAME 3 PLAT: BUCKLEY RIDGE ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: §41 New ❑Addition/Alteration CENSUS CODE R-1A 1.41 Description:l8'X36' INGROUND POOL 329 - OTHER CATEGORY R.I Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other. 18'X36' INGROUND POOL ❑Public Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION E 8015 ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO. ❑Yes )4 No ❑Yes )4 No ❑Yes )4 No HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 648 648 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR ard FLOOR $ 42,000.00 PERMIT FEE 0 Sq.Ft. Sq.Ft. $ 99.00 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 f the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of compliance or until earlier r o d in writing by the owner of the property. SIGNATU-=: • ner/A ent' DATE• / Owner 8 es.Agent Any hereby agree to comply with all Dane County / g ��//� ��( Ordinances.Any unauthorized change from the information %' ei or plans submitted will invalidate the permit .� OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPE TIO ATE INITIALS ❑Ye ,v No 08 May 2009 pmk2 6/ �' `1/d/ 1e DATE REVIEWED INITIALS 2nd INS 6 TIpN DATES 9 INITIALS Initials: /Z /�/ 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE Condit ions: PROJECT REQUIRE THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF ANY ' % ATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. INITIALS /E 2. SURVEY AD ISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE BUI I G IS CON UCADING TO THE PLAN SUBMITTT,D�L15H THIS APPLICATION. Z ! o/24 //'Sep, 7L s friC sas-i�a lisros) GCS-s al � 4'