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Ap.Iication Number:APP-21293 <br /> DANE COUNTY ZONING PERMIT ZONING PERMIT NO. <br /> ZP20080316 <br /> OWNER INFORMATION AGENT/CONTRACTOR INFORMATION <br /> OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE <br /> LONNIE GRAU (608)835-7675 FORSTER CONSTRUCTION LLC (608)835-2524 <br /> BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) <br /> 4872 COUNTY HIGHWAY A 4458 HILL RD <br /> (City,State,Zip) (City,State,Zip) <br /> OREGON,WI 53575 OREGON,WI 53575 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 <br /> 0509-241-9270-7 OREGON 24 NE SW <br /> Li;to]a 1 I i-/_1 r]'1:4*1 HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE <br /> (Assignment of new address is subject <br /> to field verification.) 4872 COUNTY HIGHWAY A <br /> LOT BLOCK C.S.M.NO.or PLAT NAME <br /> METES AND BOUNDS: METES AND BOUNDS <br /> ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: ❑New gl Addition/Alteration CENSUS CODE <br /> A-1 EX 1 DescriptioVX26 DECK W ACCESS RAMP(30X4) 434 - RES ADD <br /> CATEGORY Residential Li Commercial ❑Agricultural SEWER SANITARY PERMIT NO. <br /> ❑Other: X26 DECK W ACCESS RAMP(30X4) ❑Public XI Private <br /> ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION <br /> B ❑Yes ❑No <br /> SHORELAND FLOOD ZONE y� WETLAND EC/SW NO. <br /> ❑Yes )4 No CI Yes Xi No ❑Yes )4 No <br /> HEIGHT(In Feet) BASEMENT 1st FLOOR TOTAL SQUARE FEET <br /> 640 640 <br /> Sq.Ft. Sq.Ft. PROJECT COST <br /> NO.OF STORIES 2nd FLOOR ltd FLOOR $ 40,000.00 <br /> PERMIT FEE <br /> Sq.Ft. Sq.Ft. $ 98.00 <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: Owner/Agent DATE: <br /> Ordinances.Any unauthorized change from the information d <br /> or plans submitted will invalidate the permit G , - S °t 5*do <br /> OFFICE USE ONLY <br /> SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSPEC ION DATE INITIALS <br /> ❑Yes :I No 29 May 2008 HJH3 i(ti D� <br /> DATE REVIEWED INITIALS 2nd INSPE i�TyGI,ON DATE INITIALS <br /> Initials: 1/4 ' <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 At'MMDIFICATIONS ARE MADE WITHOUT THE EXPRESS WRITTEN APPROVAL OF DANE COUNTY ZONING. <br /> INITIALS / + <br /> 2. SURVEY ADVISORY NOTE: A LOCATION SURVEY MAY BE REQUIRED TO VERIFY THAT THE <br /> BUILDING IS CONSTRUCTED ACCORDING TO THE PLAN SUBMITTED WITH THIS APPLICATION. <br /> 545-112(12/05) GCS-single <br />