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TOWN OF OREGON <br /> APPLICATION FOR LAND USE CHANGE <br /> Submittal Fee: $100.00 each submittal plus $20.00 per additional petition.* <br /> 1. NAMES-Own& 144,479 j n -vc., Applicant(if other than Owner) <br /> Name ems' -"E, z-Lc ,-.-ST-S Name ?t4-y,-lc f L.Kt,-1, -1-4c, 811-#4. CG-,d; <br /> Street Po rick q 42_a9 q i s7c;��-! '� Street ,(L? w L 3 5� i�•a O , eve_ t/L� "J '„�S t'� <br /> vtA�a,3�se,,,wi ��.�L ' Ly�, wr <br /> City, State, Zip,5-37yt/"L/ 35f 5-3C-2-/ City, State, Zip t'"' L- 5 t 1A-1( S 1 7 <br /> Phone: Days Cell Phone: DaysC2-6 Z) Cell ( a) 3 c-4-‘ ..Y 2 9 <br /> ,SLR- t?co - ii35-0/c _ t9S01 e <br /> 2. PROPERTY LOCATION ? Lg oo o - t� s-7t� <br /> Section: 34. Property size: I OO property zoning: 4l' Z Parcel No(s).:os-b53 /8c( C O - X81 0o3 <br /> Property Address 11/1W) ih✓L°C 1 --L`y N` /,t)I _ !`1 '10 -(48(Do"2 i. <br /> 3. REQUEST: Applicant must review town ordinance requirements for submittal. Applicant is also <br /> responsible for filing necessary paperwork with the County. <br /> ❑ Nonresidential Site Plan Review (Ordinance 10.1.9) <br /> 1. Required for any construction, expansion or conversion of structures other than single family residences, <br /> agricultural structures or agricultural accessory buildings. <br /> 2. Submit 13 sets of site plans. <br /> 3. Submit the Site Plan Review Application. <br /> 4. Site Plan Review for <br /> ❑ Land Division or Certified Survey Map (CSM) (Ordinance 10.10.4) <br /> 1. Required for any land division that creates 2, but not more than 4 lots. <br /> 2. Has a Density Study Report by Dane County been completed? <br /> 3. Submit 12 copies Proposed & Final Certified Survey Map (CSM). <br /> 4. Submit the Town of Oregon Land Division Application. <br /> 5. Submit a copy of the completed Dane County Land Division Application. <br /> Cr 6. If applicable, may require approval from the Village of Oregon. <br /> 7. Reason for land division <br /> ❑ Plat or Subdivision (Ordinance 10.10.4) <br /> 1. Required for any land division that creates 5 or more lots or a subdivision. <br /> 2. Has a Density Study Report by Dane County been completed? <br /> 3. Submit 12 copies of Preliminary & Final Plat. <br /> 4. Submit the Town of Oregon Land Division Application. <br /> 5. Submit a copy of the completed Dane County Land Division Application <br /> 6. If applicable, may require approval from the Village of Oregon. <br /> 7. Reason for plat or subdivision <br /> ❑ Zoninq Amendment <br /> 1. Required for any change in zoning district. <br /> 2. Zoning change from District to District for acres <br /> 3. Submit a copy of the completed Dane County Zoning Change Application. <br /> ky 4. Reason for change <br /> Conditional Use Permit (CUP) <br /> 1. Required for any change in the use of property that requires a conditional use in the zoning district. <br /> 2. Submit a written statement of the intended use of the property. <br /> 3. Submit a copy of the completed,Dane County Application for a Conditional Use Permit (CUP). <br /> 4. Conditional Use Permit for ,,Kk m '"l-e Li c_ /i/i 2- L EV C2 7 O'J <br /> ❑ Variance S 'o F <,",2'4."2 Pt') <br /> 1. Required for any request for variance from the County Zoning Code. <br /> 2. Submit a copy of the completed Dane County Variance Application <br /> 3. The Applicant will receive a letter from the Town acknowledging that they informed the Town of <br /> their intent to apply for a Variance. *Requi ed by Dane County. <br /> 4. Variance for �4 <br /> 4. SIGNATURE ?_/ <br /> Owner(signature is mandatory) Date 'pplicant (if other tha liner) Date <br /> *Pre-Application Consultation with Plan Commission is recommended before submitting <br /> any application or payment of fees. There is no charge for consultation. <br />