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• Ap.lication Number:APP-23643 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20080548 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> KEVIN JULSETH (608)212-5932 CHRIS MILLER CONSTRUCTION (608)877-1366 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 1051 TOWER DR 3186 KINNEY RD., <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 COTTAGE GROVE, WI 53527 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/a 1/4 1/4 <br /> 0611-252-9325-0 PLEASANT SPRINGS 25 NW SW <br /> J (•7 J I a i"/_1'l'7:7 441E/HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 2016 TOWER DR <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> 1 CERTIFIED SURVEY MAP: CSM 12430 <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: New ❑Addition/Alteration CENSUS CODE <br /> A-2(4) 7.12 Description:SFR W/DECKS& PORCH 101 - SFR <br /> CATEGORY XI Residential ❑Commercial LI Agricultural SEWER SANITARY PERMIT NO. <br /> CI Other:SFR W/DECKS & PORCH ❑Public ?I Private 517956 <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C 9809 ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> ��{{ <br /> ❑Yes No ❑Yes ,t�1 No ❑Yes I No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 14 2085 3507 5592 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 200,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 469.00 <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 8• 4 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSP CTIO DAT INIT <br /> I=1 Yes )l No 04 Aug 2008 SCW1 d TI O <br /> P <br /> // DATE REVIEWED INITIALS 2nd INSP DATE <br /> t IN � <br /> Initials: • M • z_-/zilog <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 AN ODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIAL /•h_ <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 />