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. . • 4 <br /> Is there a•hquse pr`building 9n,this site now?14 yes I I no <br /> Has an application'for'iezone on this parcel been previously submitted? L1 yes pCno <br /> Is this the original tract of land from 1978? 0 yes V, no <br /> Has the property been previously rezoned? yes H no <br /> If yes, how many times? r;, 1 ❑ 2 ❑ 3 <br /> Explain land divisions, provide dates and attach documentation. 2 13,4604- 3S gc- <br /> J7/t//DG--D oc f?/rw hA o fuotc) E /iv iq /3x35 <br /> /9--,2- 7 /tLaw Age/5c 51 us /4) /S'ss <br /> Have you notified landowners within 1/4 mile of your intent to rezone?$7 yes 0 no <br /> Have you filled out'an application with Dane County? 0 yes *11 no <br /> CONDITIONAL USE PERMIT(CUP) AND VARIANCE REQUEST <br /> Is there presently a: ❑ CUP or ❑ variance on this parcel? <br /> If yes,explain: <br /> Are you requesting a: 0 CUP or 0 variance? Intent or purpose for: <br /> 7 T:ti [.. � f ��{ A�� �t�'S ��`�' <br /> 1 <br /> Before your request will be placed on the Plan Commission agenda for consideration: <br /> ❑ This form must be filled out completely,with any necessary attachments. <br /> O A $25.00 application fee must be made, payable to the Town of Pleasant Springs,when you <br /> submit this application to the Clerk/Treasurer. <br /> ❑ Obtain an "Information and Requirements for Application" handout. <br /> Town of Pleasant Springs Form(s)you may need: (In order to insure the fastest and most efficient <br /> process, make sure you have all the forms you need. If you have questions, please call your contact <br /> person.) <br /> O House Replacement Application Form <br /> ❑ Driveway Placement Form <br /> ❑ Application for Land Division Approval <br />