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' Application Number: APP-35627 ZONING PERMIT NO. DANE COUNTY ZONING PERMIT Page 1 of 2 '- 49 CI OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE DANA DUPPLER (608)424-6060 SAME AS OWNER 1ZE C 1 t PT O tea. BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) t� 6,906, PAoL1 e0 (City,State,Zip) 53500-94-91 (City,State,Zip) ! • BELLEVILLE,WI 53508-9787 f E-MAIL ADDRESS E-MAIL ADDRESS PARCEL NO. TOWNSHIP SECTION 1/4 1/s 1/4 0508-034-7501-4 MONTROSE 03 SE SE •J ts1 14 At r/d.1.1:1* HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject 6904 PAOLI RD to field verification.) LOT BLOCK C.S.M.NO.or PLAT NAME 1 11 PLAT: PAOLI PLAT ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New I Addition/Alteration !CENSUS CODE C-1 0.083 AC Description:RECONSTRUCTION OF EXISTING COMMERCIAL BUILDING 437- NON-RES ADD CATEGORY ❑Residential Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other: t Public ❑Private NR ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION B -- -- 3567 ❑yes ❑No SHORELAND FLOOD ZONE WETLAND EC/SW NO. Yes 0 N Dyes No ❑Yes No SEE NOTE HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET 14 0 1600 1600 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 53,650.00 1 0 0 PERMIT FEE Sq.Ft. Sq.Ft. $ 616.00 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 until earlier revoked in writing by the owner of the property. Owner&Agent hereby agree to comply with all Dane County SIGNATURE: Owner/Agent DATE: Ordinances.Any unauthorized change from the informati• p or plans submitted will invalidate the permit "�� 11L1: /6-Lh °j7 OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st •,•ECTION I ATE INITIALS ❑Yes1 No 14 Jul 2009 KLS l - ,J — U P P-0 DATE REVIEWED A INITIALS � 2nd IN�ECTIO ATE � INITIALS Initials 7 (:) n o P M — T/� 0 • 14 Conditions: 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICAT•. O TH PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULW..a I y.• MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING.IN • elm' 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. 545-112(12/05) GCS-multi Pc.t=„ G SIC) ,,..) DAI-E. IN I 4L 11� Tis -� f e �-(� -Y C k) k)e X T- PA c, E