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Ap•Iication Number:APP-22905 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> • ZP20080469 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> JOSEPH MITCHELL (608)877-1997 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 2728 BURRITT RD <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON,WI 53589 <br /> E-MAILADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 Y/4 1/4 <br /> 0611-321-4527-3 PLEASANT SPRINGS 32 <br /> 11111:1:(81 J I[i l_\II r7:i 4*1.1 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 2728 BURRITT RD <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.of PLAT NAME <br /> 17 PLAT: OAK KNOLL <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New ❑Addition/Alteration CENSUS CODE <br /> R-2 0.42 Description:32'-6"X13'-9"FRONT DECK 434 - RES ADD <br /> CATEGORY XI Residential LI Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other:32'-6"X13'-9" FRONT DECK XI Public ❑Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> E ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND EC/SW NO. <br /> )4 Yes ❑No ❑Yes No ❑Yes )4 No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 428 428 <br /> Sq.Ft. Sq.Ft., PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 5,000.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 82.00 <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 SIGN' URE: Own ent DATE: <br /> Ordinances.Any unauthorized change from the information ifr/Y <br /> 7-t-M' <br /> or plans submitted will invalidate the permit / <br /> OFF!CE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DAT INITIA <br /> ❑Yes l No 09 Jul 2008 DJE1 / <br /> DATE REVIEWED INITIALS 2nd INSPEZCTIOND��� INIT/IS�� <br /> Initials: 11 z� <br /> `/% <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 A DIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS <br /> 545-112(12/05) GCS-single <br />