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Ap.Iication Number:APP-29025 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20080908 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> DONS MOBILE MANOR INC (608)206-1654 JENNIFER PFAFFLY (608)206-1654 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 5435 KALESEY CT 5441 KALESEY CT UNIT 77 <br /> (City,State,Zip) (City,State,Zip) <br /> WAUNAKEE,WI 53597 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JENNIFER.PFAFFLY @INVITROGEN.COM <br /> PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0808-224-8160-9 SPRINGFIELD 22 SE NE <br /> 11/d rl r7:l 1*-11111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 5441 KALESEY CT#77 <br /> LOT BLOCK C.S.M.NO.Q PLAT NAME <br /> METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New ❑Addition/Alteration CENSUS CODE <br /> R4 0 Description:SFR 18 X 80 W/DECK 101 - SFR <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑other SFR 18 X 80 W/DECK ❑Public :t4 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 /> ��yy <br /> ❑Yes p,t No ❑Yes No 23 Yes ❑No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 14 1504 1504 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 4,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 163.00 <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 /> f-n ' <br /> Owner&Agent hereby agree to c o m p l y w i t h all Dane County SIGNATURE: O r/A t DATE: <br /> Ordinances.Any unauthorized change from the information p .�, r r 0//'0 4 <br /> or plans submitted will invalidate the permit <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes XI No 01 Dec 2008 CHS1 <br /> „y/� DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: C <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE <br /> Conditions: PROJECT REQUIRE THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND <br /> VOID IF AN `11 •ATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS ,./A, <br /> 2. SUR Y 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 <br /> ����6- i„Dtxc,5 Cu--co PL �� <br />