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A location survey, by a licensed surveyor, is required if yoursign <br /> is within 10 feet of a setback line. <br /> • You will need to hire a surveyor to prepare a location survey to verify the construction location. <br /> • Note: A location survey may add significant cost to your project. Please contact a Wisconsin Licensed Land <br /> Surveyor. <br /> 1. I, the undersigned, hereby make application for a zoning permit only for the location and the work described herein and <br /> certify to the accuracy of that information. I further certify I am the property owner, or a duly authorized representative, <br /> and may sign this permit application on behalf of the owner(s) of said property, and I have read and understand all of <br /> the conditions of this permit and will construct the project in compliance with those conditions. I understand that failure to <br /> provide accurate information or to comply with any provisions of the permit renders it null and void and may result in an <br /> enforcement action. <br /> 2. I, the undersigned, hereby consent to the entry on the permitted premises by zoning inspectors of the Dane County <br /> Department of Planning&Development to determine compliance with the county's zoning ordinances.This consent is <br /> valid for the period commencing with issuance of this zoning permit and terminating with issuance of a certificate of <br /> compliance or until earlier revoked in writing by the owner of the property. <br /> 3. I, the undersigned, hereby agree to comply with the illumination standards of the Dane County Zoning Ordinance. <br /> PRINT: Owner/Agent DATE: <br /> Dan Pietrzykowski, Grant Signs on behalf of Flannel Jaxs 6/15/21 <br /> SIGNATURE:Owne / ' <br /> .rte - -/ rff <br /> DANE COUNTY PLANNING AND DEVELOPMENT <br /> ZONING DIVISION <br /> ROOM 116, CITY COUNTY BUILDING <br /> 210 MARTIN LUTHER KING JR. BLVD. <br /> MADISON WI 53703 <br /> (608)266-4266 <br />