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<br /> ..,,, .....a.r. h ,!„fife.%tip t'y ! Dane Coun ty Planning & Development
<br /> v.;,; lit 0A�?s= . Division of Zoning
<br /> Land Division Application
<br /> In order for applications to be processed, all information, survey drawings, application signatures
<br /> and fees required must be submitted at time of application. Please check the appropriate box
<br /> below for the type of application being submitted:
<br /> XPreliminary Certified Survey Map ❑ Certified Survey Map
<br /> ❑ Subdivision Preliminary Plat* ❑ Subdivision Final Plat
<br /> *As per DCCO Ch.75-Prior to filing an application for approval of a preliminary plat,the subdivider
<br /> shall consult with staff of the committee for advice,assistance and for the purpose of reviewing the
<br /> procedures and requirements of Chapter 75 and other ordinances,plans or data which may affect the
<br /> proposed development.
<br /> Property Owner Information �1\ 1044 Surveyor Information 1
<br /> Name A 1(140 Y F 4 - nr ` i, i`.' !,I/�
<br /> Address �q b5 1124)04e-6il-oo k vt�1�w i Al ILO�U , �
<br /> ti, r>11-a t/th b ' 5({-%
<br /> Phone Number 35- 36 4 C( q 4-s- / 4q
<br /> E-Mail Address WS. 6 e I er le . ,to Cdh'1 ii—CO,1 I $�J v 7-1 , N t' /
<br /> Property/Location Information (accessdane.co.dane.wi.us)
<br /> Township 0 V'•/„6/J Section 74_ 'in '(,Ai Y.'A 7(A Acreage y4
<br /> Parcel Number(s) u^5-6C U3 !Vto1 6S�q 2434600,1 0c01Z' 3 44,. ..
<br /> Current Zoning _ (t f k Proposed Zoning OW N ex, CI ra i cg A - D1
<br /> CSM N L Lot Subdivision Block/Lot
<br /> 1. Is proposed land division associated with a rezone petition?
<br /> Yes pIlo ❑ ETZ ❑ If Yes, Petition#
<br /> 2. Does the property abut or adjoin a County or State Trunk Highway?
<br /> Yes ❑ No If Yes, Highway Name:
<br /> 3. Will public sewer serve the land division?Yes ❑ No$..,
<br /> 4. Does the subdivision have significant features like shoreland,wetland and/or floodplain? Yes ❑ No
<br /> If Yes, describe features :
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