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Ap.lication Number:APP-27878 <br /> • <br /> ' DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20080824 <br /> • OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> KENNETH AIRGOOD (608)655-3216 SAME AS OWNER (608)333-5023 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 621 CHRISTIANSON WAY <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0812-162-9220-0 MEDINA 16 NW SW <br /> ;Tel J 4:11 i i OI L1,111:4*1-1111HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 5691 OAK PARK RD <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 3 CERTIFIED SURVEY MAP: CSM 02879 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: Xi New ❑Addition/Alteration CENSUS CODE <br /> A-1 EX 6.64 Description:54'X 36'X 20'MACHINE SHED 328-OTHER NON-RES <br /> CATEGORY ❑Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other:54'X 36'X 20' MACHINE SHED 0 / 2 .3(i)A ) ❑Public X Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. /// VARIANCE NO DEED RESTRICTION <br /> C ❑Yes ❑No <br /> SHORELAND FLOOD ZONE �y{ WETLAND EC/SW NO. <br /> XYes 0 N ❑Yes XNo ❑Yes )3.1 No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 20 1944 1944 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 24,000.00 <br /> PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 196.00 <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 /> 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 INSPECTIO DATE INITIALS <br /> ❑Yes ;�I No 24 Oct 2008 RLB %�'/�/o7 r� <br /> DATE REVIEWED INITIALS 2nd INSPECT N DATE INITIALS <br /> Initials: i��0 1W <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. 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 ANY MODIFICATIONS AR MA}E WITHOUT T E SS j II EN A PIROVVAL OFpA�IE COUNTY ZONING. <br /> INITIALS /D•2,T 3 1C1.�) /6. ZS�(y)(G)b yrie L i/od 1/ z ,'t phi 4 Ci <br /> 2. SURVEY ADVISORY NOT : 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 in .(/l j fe v e led ////7`V r� <br />