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Application Number: WEB-21715 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20080539 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> CHRISTIAN RUCK (608)884-8566 SAME AS OWNER (608)884-8566 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 536 REUTERSKIOLD <br /> (City,State,Zip) (City,State,Zip) <br /> EDGERTON,WI 53534 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> CRUCK @TDS.NET CRUCK @TDS.NET <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0512-223-5029-3 ALBION 22 SW SW <br /> :LW 2 4 c1'1 r7:1 1M HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 536 REUTERSKIALD CT <br /> LOT BLOCK C.S.M.NO.Qr PLAT NAME <br /> 59 PLAT:ALBION,ASSESSOR'S PLAT OF VILLAGE <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New gI Addition/Alteration CENSUS CODE <br /> R-2 0.6543 Description:26'X 6' PANTRY, LAUNDRY RM ADDN TO SFR 434 - RES ADD <br /> CATEGORY Xi Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: 26'X 6' PANTRY, LAUNDRY RM ADDN TO SFR gl Public ❑Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> C ❑Yes 0 N <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> X Yes ❑No ❑Yes X No ❑Yes X No SE20080210 <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 156 <br /> 14 Sq.Ft. Sq.Ft. 156 PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 18,750.00 <br /> O O PERMIT FEE <br /> Sq.Ft. Sq.Ft. 62.00 <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 \ / ?///0 <br /> or plans submitted will invalidate the permit <br /> • <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION D E INIJ) <br /> ❑Yes X1 No 01 Aug 2008 RLB Qg ;�JJ��py� <br /> DATE REVIEWED INITIALS 2nd IN I TES `% J S <br /> Initials: ��� C ('J]7 <br /> 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PR SENTED. 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 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 />