Laserfiche WebLink
TOWN OF VERONA •IA 1 <br /> APPLICATION FOR LAND USE CHANGE <br /> Please review the Town of Verona Comprehensive Land Use Plan and Subdivision and Development Ordinance 05-04 <br /> 'found on the Town website: www.town.verona.wi.us)and Dane County Ordinances Chapter 10-Zoning, Chapter 11 — <br /> Shoreland, Shorland-Wetland and Inland-Wetland Regulations and Chapter 75—Land Division and Subdivision <br /> Regulations prior to application. <br /> APPLICATION IS MADE to the Town of Verona Board for a land use change for: <br /> Property address/legal description Ob 2e, z q L7 ,,&d e 0,5----5e�.5!7043 ° <br /> o ace q 47oMo ,e �e). > 0 -— 06 0/�. 9. 'oo/k. <br /> Please check all that apply: t <br /> ❑ comprehensive plan amendment <br /> `. -rezone petition 3 <br /> current zoning category /T ,a, � ; 1 <br /> new zoning category requested A — 3 'A , a <br /> ❑ conditional use permit f i t . I' ,' <br /> conditional use requested ' to l r <br /> ❑ certified survey map 1 i � T :7 <br /> ❑ preliminary plat i tt i fi. <br /> ❑ final certified survey map <br /> ,. f f <br /> ❑ concept plan <br /> ❑ site plan <br /> ❑ request for Town road access 1,JQC €u Property Owner: ms- !/�Q C L Phone# ,C 8 33 `Cpci Pa- <br /> Address: }13 ( N�CA 04 Oc k L t� E-Mail NS L1.)gq I�eU 7riPS , ti et <br /> r <br /> Applicant: Owner Agent <br /> Applicant's Phone#:/—Mai i tr f- /r'�1- 1(— E-Mail tVl Vi-7 //J(.2` d/ii'1( i-ien, l--, <br /> L✓, . Li.; <br /> If the applicant is different from property owner,please include documentation authorizing application on behalf of property owner <br /> I her:. thorize V O w tit 0—C L)e V O IA <br /> to ac <br /> y age in e pplication process for the above indicated land use change. - <br /> Signature Date <br /> Description of Land Use Change requested;(use reverse side if ad{ltional space is needed) <br /> ,/ 1--v-, "IV 7- ' t f' /4/a//1-517)-1 , <br /> //� �� /iv( �, _/`�, - 2.�yr� �_ <br /> !� 1-fr- Z/ <br /> I certify that all Information is trufa and c rrect. I ctexstand that failure to provide all required infer tion will be grounds for denial of my request <br /> Applicant ignature Date <br /> print Name , ? i4, 4-__AL,2... dli <br /> • <br /> I RETURN COMPLETED APPLICATION PRE-APPLICATION MEETING: <br /> AND.12 COPIES OF MAP/PLAN TO: <br /> Amanda Arnold, Planner/Administrator A pre application meeting or initial review.may <br /> Town of Verona be scheduled with Town Staff and/or Plan <br /> 335 N.Nine Mound Rd Commission Chair <br /> Verona.WI 53593-1035 608-845-7187/608-845-7143 Fax <br />