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( <br /> Re_\1 .4sek e clec14s4 <br /> = Application Number:WEB-28115 <br /> • DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20080847 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> SCOTT KITTLESON (608)832-8325 SAME AS OWNER (608)832-8325 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 10073 COUNTY HIGHWAY A <br /> (City,State,Zip) (City,State,Zip) <br /> MT HOREB,WI 53572 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> CSKITTLE @MSN.COM CSKITTLE @MSN.COM <br /> PARCEL NO. I TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0506-224-8050-0 PERRY 22 SE NE <br /> 111111:(41 :4 i/_16l DI 44,211 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 10073 COUNTY HIGHWAY A <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 10485 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New 1E1 Addition/Alteration CENSUS CODE <br /> RH-3 15.35 Description:MASTER BEDROOM/FAMILY ROOM ADDITION TO SINGLE-FAMILY RESIDENCE(SFR) 434 - RES ADD <br /> CATEGORY g Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: ❑Public 1E1 Private 143031 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B 8445 ❑Yes ❑No <br /> SHORELAND �I FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes pt No ❑Yes No ❑Yes )4 No <br /> HEIGHT(In Feet) BASEMENT 1JIl FLOOR TOTAL SQUARE FEET <br /> 1424 <br /> 24 Sq.Ft. 364 672 <br /> Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR $rd FLOOR $ 85,000.00 <br /> 388 PERMIT FEE <br /> 2 Sq.Ft. Sq.Ft. $ 156.90 <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 8 Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information <br /> or plans submitted will invalidate the permit. <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE / INITIALS <br /> ❑Yes A No 31 Oct 2008 SCW1 ec 2008 /o2^L T rtki. K <br /> DATER IEWED INITIALS 2nd INSPECTION DATE I TIA <br /> Initials: 11. 3 ,_'0(3 -c <br /> 1. S APPROVAL DANE O AO <br /> Conditions. PROJECT REQUIRES BY THE EXPRESS COUNTY WRITTEN Z NING APPROVAL IS ONLY FOR BY THE DANE PLAN COUS NTY ZONING.PRESENTED.THIS ANY PERMIT MODIFICATI SHALL N BE TO NU TLL HE <br /> 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 <br />