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Application Number: WEB-28562 <br /> ZONING PERMIT NO. <br /> DANE COUNTY ZONING PERMIT Page 1 oft ZP20080898 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> RICHARD PROCTER (608)577-3941 MARK NELSON (608)205-9557 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 2790 KOSHKONONG 277 MAIN <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 STOUGHTON,WI 53589 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> MARK.NELSON @TH EOCIGROU P.COM <br /> PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0611-083-9800-0 PLEASANT SPRINGS 08 SW SE <br /> J:Z411 4Ii i'/101 X1:1*TAM HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 2790 KOSHKONONG RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME , <br /> 1 CERTIFIED SURVEY MAP: CSM 10969 <br /> I <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New L Addition/Alteration CENSUS CODE <br /> RH-1 2.4 <br /> Description:RE-BUILD OF FIRE DAMAGED SFR 101 - SFR <br /> CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑other: RE-BUILD OF FIRE DAMAGED SFR ❑Public Private 435404 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C 8809 ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> Li Yes No Li Yes No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT jf FLOOR TOTAL SQUARE FEET <br /> 18 1720 2336 4056 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 158,400.00 <br /> 1 0 0 PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 354.00 <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 lid for the period co mencing with issuance of this <br /> zoning permit and terminating with issuance of a certificate of compliance or until e er revokes t wri i by the ow er of the property. <br /> /AfL/(. /t. / C�5/s <br /> Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information _ 4 1/ 4/6 <br /> or plans submitted will invalidate the permit 0 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTI D T INITIAL I / <br /> ❑Yes XI No 24 Nov 2008 HJH3 t�/ � ', <br /> A/ DATE REVIEWED INITIALS 2nd INSP TI/AT O INITIAL,B /( <br /> Initials: //�'L � `/�Jw') <br /> Conditions. 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENT D. AN MODIFICATION TO THE PROJECT <br /> REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS P RMIT SHALL BE NULL AND VOID IF ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.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(12105) GCS-multi <br />