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•IrY or <br /> : pia Dane County Planning & Development <br /> Room 116, City-County Building, Madison, Wisconsin 53709 Land Division Review <br /> is F_ 608.266-9086 <br /> Property Listing <br /> 608/266-4120 <br /> Surveyor <br /> 608/266-4252 <br /> Zoning <br /> CERTIFICATION OF OFFICIALLY MAPPED AREAS TO APPLICANT'S LANDS <br /> 6081266-4266 <br /> The undersigned applicant for a zoning permit under Chapter 10 of the Dane County Ordinances thus <br /> certifies as follows: <br /> 1. That he or she has made diligent inquiry into the applicability of any official map to the <br /> applicant's land. <br /> 2. That no such official map is applicable or, if such map is applicable, the approval of the <br /> appropriate city or village has been obtained. <br /> 3. That the applicant has not relied upon any statements of County employees in giving these <br /> assurances. <br /> 4. That the applicant understands the possible adverse consequences of erecting any structure <br /> within an officially mapped area without the proper approval of the city or village involved. <br /> Any zoning permit issued for a property located within an officially mapped area for which <br /> the applicant has not obtained the proper permit from the appropriate village or city shall be <br /> null and void. (Ref§10.25(6)(b)and(d)Dane County Zoning Ordinance) <br /> Dated this Z7 day of , 19 S,at Madison.Wisconsin. <br /> Signed: <br /> Witness: <br /> Zoning Permit#: <br /> FORMSLIB:CERT MAPPED AREAS APPLI'S LAND(3/98) <br /> o.> <br />