DCPZP-2008-00847 - Laserfiche WebLink

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RER vISf rvc_iud ul( Ap•lication Number: WEB-28115 DANE COUNTY ZONING PERMIT b ZONING PERMIT NO. S e m ZP20080847 OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE SCOTT KITTLESON (608)832-8325 SAME AS OWNER (608)832-8325 BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 10073 COUNTY HIGHWAY A (City,State,Zip) (City,State,Zip) MT HOREB, WI 53572 E-MAIL ADDRESS E-MAIL ADDRESS CSKITTLE @MSN.COM CSKITTLE @MSN.COM PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 1/4 0506-224-8050-0 PERRY 22 SE NE NI:7:1•I a 4 it i/A 114:1*I-1.1 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject to field verification.) 10073 COUNTY HIGHWAY A LOT BLOCK C.S.M.NO.or PLAT NAME 1 CERTIFIED SURVEY MAP: CSM 10485 ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT ❑New M Addition/Alteration CENSUS CODE RH-3 15.35 Description:MASTER BEDROOM/FAMILY ROOM ADDITION TO SINGLE-FAMILY RESIDENCE(SFR) 434 - RES ADD CATEGORY ',Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other: ❑Public 1Z1 Private 143031 ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION B 8445 ❑Yes ❑No SHORELAND FLOOD ZONE �t WETLAND �t EC/SW NO. ❑Yes X No ❑Yes X1 No _❑Yes X No �, HEIGHT(In Feet) BASEMENT "-- 1st FLOOR TOTA SQUARE FEET /(lot y r Q q ' 24 Sq.Ft. 364_ Sq.Ft. � IoZ PROJECT COST NO OF STORIES 2nd FLOOR •� 3rd FLOOR $ 85,000.00 3 0 PERMIT FEE 9© •,c• 2 2 Sq.Ft. Sq.Ft. $ 1 S CO. 458.6 o- .13$ 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 9-. 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 1 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 acti n. 1(ft.. 2. I,the undersigned,hereby certify that: cL�, d t o)l• • I have made a diligent inquiry into the applicability of any official map to the applicants'land; V-0? • No such official map is applicable,or,if such map is applicable,the approval of the appropriate city or village has been obtained; 1 • 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 for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of compliance or until earlier revoked in writing by the owner of the property. Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INIT LS ❑Yes I No 31 Oct 2008 SCW1 03 61'Li 0$ 1'M K. DATE REVIEWED INITIALS 1 2nd INSPECTION WE INITIALS Initials: 11—•3^©� P '4)' — d 5" e 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE Conditions: PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID IF ANY MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. INITIALS 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. 545-112(12/05) GCS-single