DCPZP-2008-00616 - Laserfiche WebLink

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Ap•lication Number:APP-24506 DANE COUNTY ZONING PERMIT ZONING PERMIT NO. ZP20080616 OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE ROBERT CAMPBELL (920)960-7856 SAME AS OWNER BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) N6959 ROCK LAKE RD (City,State,Zip) (City,State,Zip) LAKE MILLS, WI 53551 E-MAIL ADDRESS E-MAIL ADDRESS PARCEL NO. TOWNSHIP SECTION y4 Y/4 Y4 0812-132-9220-6 MEDINA 13 NW SW :t•]14 ail/_10l'l:1#= 1.1 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject to field verification.) 5721 DOSCHADIS RD LOT BLOCK C.S.M.NO.Q PLAT NAME METES AND BOUNDS: METES AND BOUNDS ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New 14 Addition/Alteration CENSUS CODE RH-1 2.75 Description:16'X 16'X 12'STOR RM & DECK ADDN TO SFR 434 - RES ADD CATEGORY .II Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other: 16'X 16'X 12'STOR RM & DECK ADDN TO SFR ❑Public Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION C 8754 ❑Yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO. Xi Yes ❑No Li Yes Yes ,+�I No ❑Yes ,4 No HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 12 256 256 512 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 7,500.00 PERMIT FEE 1 Sq.Ft. Sq.Ft. 88.00 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 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 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 action. 2. I,the undersigned,hereby certify that: • I have made a diligent inquiry into the applicability of any official map to the applicants'land; • No such official map is applicable,or,if such map is applicable,the approval of the appropriate city or village has been obtained; • 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 un' earlier revoked in writing by the owner of the property. Owner&Agent hereby agree to comply with all Dane County Si r -1 O r/Agent DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit era 1 4 9.26-CO OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTIO DATE INI A CI Yes xI No 26 Aug 2008 RLB /o ��/d I il DATE REVIEWED INITIALS 2nd INSPE -rIr DATE �e ^ INITIALS Initial S�///c/,t/// 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 A troy z,DIFICATIONS ARE M DE WIT UT HE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. INITIAL A - Al t(/ 5 �JD / 7, A) I° //eky I1 cck . " (4 sc- ►- o �a . 1/'es 545112(12/05) GCS-Ingle �- 1 g9t9 ,,,c.. f,eV. e aj-j- ; AA Cve,w..c4 icy o eer