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Ap•lication Number:APP-26306 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20080772 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME P <br /> DANIEL MEYER (708)308-9933 SAME AS OWNER ,,I. <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) C <br /> 12918 S HIGHLAND AVE <br /> (City,State,Zip) (City,State,Zip) )BLUE ISLAND, IL 60406 r-�� 1\ 6 <br /> E-MAIL ADDRESS E-MAIL ADDRESS Ov �4Q`"fl <br /> DANIEL.G.MEYER@EMDIESELS.COM EMDIESELS.COM C. <br /> PARCEL NO. TOWNSHIP SECTION I ` 1 1/4 1 <br /> � �4 <br /> 0512-254-2261-0 ALBION opMa4 SE Nw <br /> III J:AI J 4:i r/ct'l'l:4*-11111 HOUSE NO. ST.DIRECTION STREET NAME • ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 390 LAKE SHORE DR <br /> LOT I BLOCK C.S.M.NO.or PLAT NAME <br /> 1 2 PLAT: EDGERTON BEACH PARK <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New XI Addition/Alteration CENSUS CODE <br /> R-3 .33 Description:RAISE HOUSE-COMPLY WITH FLOODPLAIN REGULATION 329 - OTHER <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: Public ❑Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> D ❑Yes ❑No <br /> SHORELAND FLOOD�ZONE WETLAND EC/SW NO. <br /> Yes 0 N )Yes ❑No ❑Yes No <br /> HEIGHT(In Feet) BASEMENT 1s1FLOOR TOTAL SQUARE FEET <br /> 0 0 0 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 10,000.00 <br /> PERMIT FEE <br /> 0 Sq.Ft. Sq.Ft. $ 50.00 <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 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 /o <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECT N DATE INITIALS <br /> AI Yes ❑No 07 Oct 2008 SSA1 t l ,Q S <br /> DATE REVIEWED INITIALS 2nd INSPECT N DATE INITIALS <br /> Initials: r` t3 10 J <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PR SE TED. 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 ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS <br /> 2. SURVEY REQUIREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH <br /> ZONING ORDINANCE SETBACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND <br /> SURVEYOR,AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE FOUNDATION/ <br /> 545-112(12/05) GCS-single <br />