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• •. <br /> Town of Vermont Office Use Only <br /> Website:townofvermont.com Application No.: Application Date: <br /> Planning Questions <br /> Phone:608-767-2457 Land Use Intent - Application Form <br /> Email:clerk@townofvermont.com 1. This form is used to submit a land use proposal to the Town of Vermont.The <br /> Town of Vermont has chosen to use a single form for all land use requests. <br /> 1 Process flow documents are available for reference as you complete the form <br /> A. Form must be received at least 2 weeks prior to the Plan Commission meeting <br /> where a request is to be addressed. <br /> Any material submitted with this application,including plans and personal <br /> information will be publically available upon request. <br /> Applicant, Property&Action Applicant Name: Street Address: Phone#: <br /> Charles and Katedl 6322 Elmwood Ave 608-628-3179 <br /> Tax Parcel# <br /> 0706-361-8820-0 City: Zipcode: E-Mail Address: <br /> Middleton 53562 crlangfeldt a( gmail.com <br /> Requested Actions(s): _ <br /> Property Address Zoning Change ✓ Home Site Approval ✓ Driveway Approval <br /> N/A [Conditional Use Mobile/Wind Tower Siting Other <br /> Complete relevant section(s)below as well as Certification section <br /> Zoning Change <br /> Property is part of a contiguous parcel containing a total of acres,which is currently zoned <br /> Total#of acres to rezone: Total number of Potential Development Rights(PDRs)associated i <br /> Proposed zoning district: _. with contiguous property: _ <br /> Number of PDRs to remain with original property: 1 <br /> Parcel to be rezoned will: Number of PDRs to be allocated to rezoned parcel: i <br /> 8 <br /> Remain under current ownership <br /> Be sold to <br /> Reason for Zoning Change <br /> r - ,i <br /> i £ <br /> Zoning Change Notes: <br /> The zoning change/rezone process involves both the Town of Vermont&Dane County—it is recommended that applicants <br /> begin the process with Dane County at the same time as the process begins with Town of Vermont. <br /> 4- It is recommended that applicant verify potential development rights via density study through Dane County. <br /> -1. Applicant must submit surveyor's map(preliminary map is acceptable)with the application and it must show the following: <br /> • The property from which the rezone parcel is to be divided <br /> • The rezone parcel,with dimensions and locations of corners <br /> • Acreages of the existing property and the rezone parcel <br /> • The location of the property relative to adjacent and nearby roads <br /> 1. Refer to process flow document at townofvermont.com <br />