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t. .t ) <br /> .37/7/09 Application Number:APP-25925 <br /> • <br /> DANE COUNTY ZONING PERMIT Page 1 oft ZONING PERMIT NO. <br /> • ZP20080738 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> KUEHN 1995 TR, BRIDGET M (608)767-2082 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 9440 BLACKBERRY RD <br /> (City,State,Zip) (City,State,Zip) <br /> BLACK EARTH,WI 53515 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> BHANDEL @TDS.NET <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0807-302-8190-0 BERRY 30 NW NE <br /> •:i:I4]:J 4:l r-/c1'1II:44 4z-1/HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 9440 BLACKBERRY RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 2 CERTIFIED SURVEY MAP: CSM 09106 <br /> NING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ]New ❑Addition/Alteration CENSUS CODE <br /> tez, <br /> RH 2 5.04 <br /> Description: ?Si <br /> ACCESSORY BUILDING 328-OTHER NON-RES <br /> CATEGORY Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: Li Public 4 J Private <br /> ROAD CLASSIFICATION REZONE N���I\ C.U.P.NO. _^ VARIANCE NO. DEED RESTRICTION <br /> C ��j/}�V ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ❑Yes No ❑Yes No ❑Yes No <br /> HEIGHT(In F, - BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> ` 1780 <br /> 'l .�� ei <br /> 16.5 1 5.1}7 Sq.Ft. (/� U Sq.Ft. 1 i� PROJECT COST <br /> . NO.OF STORIE 2nd FLOOR 3rd FLOOR $ 75,000.00 <br /> 1 PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 183.00 <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 SIG ATURE: Owner/Agent A : /Or <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 No 29 Sep 2008 SSA1 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: 12A- <br /> Conditions: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE PROJECT <br /> REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND VOID I ANY <br /> MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.INITIALS <br /> 2. ACCESSORY BUILDING-NO COMMERCIAL: THIS BUILDING SHALL NOT BE <br /> USED FOR ANY BUSINESS OR COMMERCIAL PURPOSE. <br /> 545-112(12/05) GCS-multi <br />