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"NOTICE OF INTENT" TO SUBDIVIDE ' <br /> REQUEST A ZONING CHANGE, AND/OR BUILD A STRUCTURE <br /> TOWN OF VIENNA <br /> Name: k ; ` ; ; 1 t E. , <br /> Address: ' r Telephone: ( ) r <br /> 1. Purpose: j <br /> 2. Legal description of parcel in question: <br /> 3. Attach map or sketch or parcel (professional, scale drawing not necessary). <br /> Please show: <br /> { <br /> (a) Road cuts <br /> (b) Dimension of land (including proposed division, if applicable) <br /> (c) Location of structures <br /> 4. Type of action requested: <br /> E3Land division <br /> Zoning request <br /> a Building permit <br /> [] Other <br /> 5. Pay fee, if applicable $ JUL 18 ins <br /> (amount) <br /> BECEVEU <br /> 6. Miscellaneous information: , MONO <br /> I (we) hereby acknowledge receipt of a copy of the Land Division and Sub- <br /> division Regulations Ordinances, Town of Vienna, Dane County, Wisconsin, and <br /> agree to pay for any professional assistance as provided for in 10.31 of the <br /> Ordinances. I (we) understand that the ordinance refers to minimum and maximum <br /> lot sizes, site layout, utilities, driveways, roads, landscaping, lighting, <br /> public areas, fees, professional land plannner review, erosion control, and <br /> installation of all improvements as it applies to all building permits with the <br /> exception of non-residential buildings. I (we) also hereby acknowledge receipt <br /> of a copy of the Town's Land Use Plan. <br /> I (we) agree to proceed in accordance with the Town's ordinances and plans. <br /> Date: Signed: { �. <br /> Date filed: % f_, / <br /> Town Clerk <br /> Planning Committee Action: r-i Date: <br /> Town Board Action: r; Date: <br /> Original - Clerk Green - Chairman Yellow - Planning Committee <br /> Pink - Building Inspector Gold - Applicant <br />