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Ap•lication Number:APP-21141 DANE COUNTY ZONING PERMIT ZONING PERMIT NO. ZP20080299 OWNER INFORMATION I AGENT/CONTRACTOR INFORMATION OWNER NAME PHONE AGENT/CONTRACTOR NAME PHONE THOMAS KOT (608)834-0931 SAME AS OWNER BILLING ADDRESS (Number,Street) ADDRESS (Number,Street) 16109 RONDEVOO (City,State,Zip) (City,State,Zip) STONE LAKE,WI 54876 E-MAIL ADDRESS E-MAIL ADDRESS KOT53590 @AOL.COM PARCEL NO. TOWNSHIP SECTION 1/4 1/4 1/4 0911-293-2428-6 BRISTOL 29 SW Nw •1 W:14:i l'/d'1.1:4**HOUSE NO. ST.DIRECTION STREET NAME ST.TYPE (Assignment of new address is subject SAM H I L L D R to field verification.) 6718 LOT BLOCK C.S.M.NO.or PLAT NAME 8 PLAT: HOMESTEAD ESTATES ZONING DISTRICT PARCEL ACREAGE PROPOSED PROJECT: W New ❑Addition/Alteration CENSUS CODE A-1 Descnption:POOL/DECK 329 - OTHER CATEGORY Xl Residential ❑Commercial ❑Agricultural SEWER SANITARY PERMIT NO. ❑Other: ❑Public )4 Private ROAD CLASSIFICATION REZONE NO. C.U.P.NO. VARIANCE NO. DEED RESTRICTION E ❑Yes ❑No SHORELAND FLOOD ZONE may{ WETLAND EC/SW NO. ❑Yes A No ❑Yes X No ❑Yes X1 No HEIGHT(In Feet) BASEMENT 1ssf FLOOR TOTAL SQUARE FEET 612 Sq.Ft. Sq.Ft. PROJECT COST NO.OF STORIES 2nd FLOOR 3rd FLOOR $ 4,000.00 PERMIT FEE Sq.Ft. Sq.Ft. $ 96.00 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 B Agent hereby agree to comply with all Dane County SIGNATURE: Owner/A ent DATE: Ordinances.Any unauthorized change from the information or plans submitted will invalidate the permit A 'C/ A -Z3 U� OFFICE USE ONLY SURVEY REQUIRED? DATE ISSUED INITIALS 1st INSP CTION 9ATE INITIALS Yes jA No 23 May 2008 DJE1 1 z-Vor- iall DATE REVIEWED INITIALS 2nd IN P CTION DATE._ INIT S Initials: 2- V r 1.THIS APPROVAL BY DANE COUNTY ZONING IS ONLY FOR THE PLAN AS PRESENTED. ANY MODIFICATION TO THE Conditions: PROJECT REQUIRES THE EXPRESS WRITTEN APPROVAL BY DANE COUNTY ZONING. THIS PERMIT SHALL BE NULL AND INITIALS ALAN ,/.DIFICATION REM©E WITHOUT THE EXPRES WRITTt�N APPRO�(AL OF DSANE COUNTY ZONI 7 A 2. SURV REQUIRE N A LOCATION SURVEY IS REQUIRED TO VERIFY COMPLIANC WITH ZONING ORDINANCE SETBACKS. THE SURVEY SHALL BE PREPARED BY A REGISTERED LAND SURVEYOR, AND MUST BE RECEIVED BY DANE COUNTY ZONING WHEN THE FO NDATION/ o 545-112(12/05) GCS-sin le /" 5 F i f0 3� s s(' a' LY6wh vtojo/t7