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`I, `f <br /> "NOTICE OF INTENT" TO SUBDIVIDE ;>+ <br /> ;. REQUEST A ZONING CHANGE, AND/OR BUILD A STRUCTURE <br /> TOWN OF VIENNA <br /> Name: ` v • li b W <br /> Address: <br /> I <br /> MIERIIIMO. _ Telephone: ( ) / 4-/67302 <br /> t\tv.., _s c,..._ \„) sv S33( f <br /> 1. Purpose: <br /> Re;-2- Y-1 - 1 <br /> 2. Legal description of parcel in question: <br /> 0 5 _ <3614 0 \ c\ 0 <br /> 3. Attach map or sketch or parcel (professional, scale drawing not necessary). <br /> Please show: <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 /> Land division <br /> ►ZQ Zoning request <br /> Q Building permit <br /> Q Other <br /> f <br /> 5. Pay fee, if applicable $ <br /> (amount) K e. <br /> 6. Miscellaneous information: <br /> ir <br /> : °,iN)%,,All . , <br /> I (we) hereby acknowledge receipt of a copy of the Land Division and Sub- <br /> Iv- 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 /> • <br /> I (we) agree-to proceed in accordance with th= •wn's ordi� =sand plans.IF <br /> Date: - Signed: !Li.. ' <br /> Date filed: / 9�c r�"' -� - - <br /> own Clerk <br /> ' Planning Committee Action: L'L DaTte: — <br /> Town Board Action: CJctr--/Ld -c� Date: 7/6/9 <br /> Original - Clerk Green - Chairman Yellow - Planning Committee <br /> Pink - Building Inspector Gold - Applicant f ' <br />