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Ap•Iication Number:APP-20200 <br /> DAN5OUNTY ZONING PERMIT ZONING PERMIT NO. <br /> . ••••• ZP20080206 <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> TOK KIM (608)839-9839 SAME AS OWNER <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 4621 CONESTOGA TRL <br /> (City,State,Zip) (City,State,Zip) <br /> COTTAGE GROVE,WI 53527 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> TOK @BADGERSTATE.COM <br /> PARCEL NO. I TOWNSHIP SECTION Y4 1/4 Y/4 <br /> 0711-034-2698-7 COTTAGE GROVE 03 SE Nw <br /> I:7 i(.1 a4 AC/111111A 4 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 4621 CONESTOGA TRL <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.er PLAT NAME <br /> 38 PLAT:WEST RIDGE ADDITION TO AMERICAN HERITAGE SUBDIVISION <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: XI New ❑Addition/Alteration I CENSUS CODE <br /> R-1 .59 Description:POOL 24' 328-OTHER NON-RES <br /> CATEGORY XI Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> LI Other.POOL 24' ❑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 /> ❑Yes XI No El Yes Yes .t71 No ❑Yes A No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR - TOTAL SQUARE FEET <br /> .4 452 652 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2n�1 FLOOR kg FLOOR $ 3,900.00 <br /> PERMIT FEE <br /> 1 Sq.Ft. Sq.Ft. $ 110.00 <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 8A.,-s, •- -- ..ree to comply with all Dane County SIGNATDRE: Owner/Agent r DATE:. <br /> Ord'• • change from the information / I 0 d <br /> - the permit <br /> OFFICE USE ONLY <br /> •-VEY REQUIRED? E ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> A Yes ❑No 01 May 2008 CHS1 <br /> I/fi1 r REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: / <br /> . DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE <br /> • -ES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND <br /> NY MODIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS ,�$ <br /> 2.SURVEY REQUIREMENT: A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANCE WITH <br /> ZONING ORDINANCE SETBACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND <br /> SURVEYOR,AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE FOUNDATION/ 0 <br /> 545-112(12/05) GCS-single <br />