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Ap.Iication Number:APP-33957 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT "°• <br /> ZP20090196 <br /> OWNER INFORMATION i AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> PATRICK ALBREGTS (608)798-3774 QUALITY WEST CONSTRUCTION INC, (608)798-3774 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 6724 ALDO LEOPOLD WAY P.O BOX 12 <br /> (City,State,Zip) (City,State,Zip) <br /> MIDDLETON,WI 53562 MT. HOREB,WI 53572 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> QUALITYWEST @YAHOO.COM QUALITYWEST @YAHOO.COM <br /> PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0808-314-0067-0 SPRINGFIELD 31 SE NE <br /> •J:(•l J 4 ti 1%11]I N*HMI HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 4880 WINNERS CIR <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 28 PLAT: BRIDLE RIDGE <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: W New ❑Addition/Alteration CENSUS CODE <br /> R-1A 1.5 Description:SFR WITH DECK AND SUNROOM 101 - SFR <br /> CATEGORY X.1 Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: ❑Public Private 518277 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E 8521 ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes X No ❑Yes X No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT lit FLOOR TOTAL SQUARE FEET <br /> 16 2617 3970 6587 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 420,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 544.00 <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 re in writing by the owner of the property. <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Ow,_ . •ent dejor DATE: <br /> o <br /> Ordinances.Any unauthorized to change p from the information / /'� <br /> or plans submitted will invalidate the permit -r//0 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes , xi No 11 May 2009 SSA? <br /> / DATE REVIE INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials:[ 4A// ------ i1� � <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 <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 /> 545-112(12/05) GCS-single -.5 1,4,4 Q --C v./VW e V ,t`_ j O /` )`/C)el— ^/..v L i-i-k <br />