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Ap•lication Number:APP-28473 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20080840 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> WESLEY NELSON (608)767-3055 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 5005 REEVE RD <br /> (City,State,Zip) (City,State,Zip) <br /> BLACK EARTH,WI 53515 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 '/4 <br /> 0806-312-8850-0 BLACK EARTH 31 NW NW <br /> M :1•1•./4:i r7d'l'l:1 4-4 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 5005 REEVE RD <br /> LOT BLOCK C.S.M.NO. PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 12318 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: 21 New ❑Addition/Alteration CENSUS CODE <br /> RH-2 6.42 Description:52'X 72'ACCESSORY BUILDING 328-OTHER NON-RES <br /> CATEGORY ❑Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> CI Other:ACCESSORY BUILDING ❑Public 14 Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C 9754 Oyes ❑No <br /> SHORELAND �t FLOOD ZONE WETLAND EC/SW NO. <br /> 1:1 Yes Yes No ❑Yes No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT 161 FLOOR TOTAL SQUARE FEET <br /> 26 FEET 3744 3744 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR air FLOOR $ 71,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 331.00 <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 /> Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: <br /> the infon»ation <br /> or plans submitted will invalidate the permit T„ti ^ � ` � 1 O t <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTIO DATE INITIALS <br /> ❑Yes 1 No 29 Oct 2008 RWL1 ( `) <br /> DATE REVIEWED INITIALS 2nd INSPEC I INITIALS V <br /> Initials: f 9 IX/ <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PR SENTED. 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 AN -MIQDIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS ) `I <br /> • <br /> 545-112(12/05) GCS-single l <br /> Wef 3711-/ <br />