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Apslication Number: APP-20469 <br /> ' DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> POBLOCKI PAVING CORP (414)476-9130 POBLOCKI PAVING CORP 4144534010 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 525 S 116TH ST 525 SOUTH 116TH ST <br /> (City,State,Zip) (City,State,Zip) <br /> WEST ALLIS, WI 53214 WEST ALLIS, WI 53214 <br /> • <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO I TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0811-334-9130-3 SUN PRAIRIE 33 SE SW <br /> •a;[.1,4:44W.1,111:I 441111 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject 4736 COUNTY HIGHWAY TT <br /> to field verification.) <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: 2 New ❑Addition/Alteration CENSUS CODE <br /> C-1 6.69 Description:CHANGE OF USE PERMIT,FUEL STATION TO CONTRACTORS YARD 329 — OTHER <br /> CATEGORY ■ A'��� SEWER SANITARY PERMIT NO. <br /> Residential- .rn ercial t <br /> QOthe,`'�01'''',4' <br /> _f3 „ ktMI w" :? A [OIV TO 6 TRi�1G�o ❑Public Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> A ❑Yes ❑No <br /> SHORELAND FLOOD ZONE WETLAND apt EC/SW NO. <br /> Y��I <br /> ❑Yes pt No ❑Yes X No ❑Yes BI No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 45.00 <br /> PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 45.00 <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 'own ,;3, DATE. <br /> Ordinances.Any unauthorized change from the information <br /> ,' <br /> : 1:,:-V4'11944 or plans submitted will invalidate the permit % u. >M 1 <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPECTION DATE INITIALS <br /> ❑Yes X No 09 May 2008 HJH3 <br /> DATE REVIEWED INITIALS 2nd INSPECTION DATE INITIALS <br /> Initials: <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 ANY Mf IFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS <br /> 2. THIS IS A CHANGE OF USE PERMIT FOR A CERTIFICATE OF COMPLIANCE <br /> 545-112(12105) GCS-single <br />