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k ' <br /> • LAND USE INTENT APPLICATION TOWN OF VERMONT <br /> Section A (To be completed by current owner) <br /> LeDh Ci�thh � <br /> Name 1-4 c, 19„i vi 5 . Property Description: <br /> Address -7 3 g/ J 'ft 9V L// I? ; w, °'` "u uy%y <br /> / (" y Y��oK 'iy <br /> • Sec <br /> Jevo � � <br /> Phone i33- 7 D Acres 34 <br /> I currently own acres allowing for potential lots <br /> according to the Town of Vermont Land Use Plan adopted 2/11/85. <br /> If this petition' is approved I will own acres retaining <br /> potential lots. The applicant will be entitled to create <br /> / residential lot(s) . Other provisions: <br /> : : : : : : s : : : : : : : : : : : : : : : : : : : : : : : : : : : : s : : : : : : : : : : : : : : : : : : : : ss : : : : : : : : <br /> Section B (To be completed by applicant) <br /> Action Requested (check as appropriate) <br /> V Zoning change from/-E Ktof19 tf for 3 .0 acres <br /> Conditional Use Permit for acred <br /> Ordinance Variance <br /> Other <br /> Describe intended uses G 'I h f - 'ES . <br /> Required Documentation <br /> 1 ) Site Plan showing: <br /> -existing and proposed structures -sewerage system site <br /> -tillable land -boundary dimensions <br /> -wooded areas -existing and proposed <br /> -slope and drainage ' roadbeds <br /> 2) Sewerage System Approval <br /> -documentation from Dane County Environmental Health signed <br /> by a sanatarian showing that a conventional septic or mound <br /> system permit is available and has been approved for the <br /> proposed site <br /> � � ,�5 3 Alr - 7 oo • .. <br />