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Is there a house or building on this site now? p9, yes II no <br /> �G <br /> /7°/77 ns oit/ Peet00519L- #/ <br /> Has an application for rezone on this parcel been previously submitted? Il yes JiOno <br /> Is this the original tract of land from 1978? ❑ yes no <br /> Has the property been previously rezoned? yes LI no <br /> If yes, how many times? 1 LI 2 U 3 <br /> Explain land divisions, provide dates and attach documentation. <br /> / r.9-r/o t/ / <br /> Have you notified landowners within 1/4 mile of your intent to rezone? yes ❑ no <br /> Have you filled out'an application with Dane County? ❑ yes g 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: ❑ CUP or❑ variance? Intent or purpose for: <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 /> 0 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 /> El 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 /> ❑ House Replacement Application Form <br /> ❑ Driveway Placement Form <br /> ❑ Application for Land Division Approval <br />