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Dane County Application Fees <br /> o l'iE"j Department of Planning and Development General: $395 <br /> O; ' Zoning Division Farmland Preservation: $495 <br /> Room 116,City County Building <br /> Commercial: $545 <br /> 411.1111 <br /> 210 Martin Luther King Jr. Blvd. • PERMIT FEES DOUBLE FOR VIOLATIONS. <br /> 4. OTA Madison,Wisconsin 53703 • ADDITIONAL FEES MAY APPLY.CONTACT DANE COUNTY <br /> (608)266-4266 ZONING AT 608-266-4266 FOR MORE INFORMATION. <br /> REZONE APPLICATION <br /> APPLICANT INFORMATION <br /> Property Owner Name: Kersten Farms LLC Agent Name: Wisconsin Mapping LLC <br /> Address(Number&Street): PQ Box 15 Address(Number&Street): 306 W. Quarry St. <br /> Address(City,State,Zip): Marshall, WI. 53559 Address(City,State,Zip): Deerfield, WI. 53531 <br /> Email Address: darrickkersten@yahoo.com Email Address: wismapping@charter.net <br /> Phone#: 608-438-3709 Phone#: 608-764-5602 <br /> PROPERTY INFORMATION <br /> Township: Medina Parcel Number(s): 0812-223-9100-1 <br /> Section: 14 Property Address or Location: 5344 State Highway 73, Marshall, WI. 53559 <br /> REZONE DESCRIPTION <br /> Reason for the request.In the space below,please provide a brief but detailed explanation of the rezoning Is this application being <br /> request.Include both current and proposed land uses,number of parcels or lots to be created,and any other submitted to correct a violation? <br /> relevant information.For more significant development proposals,attach additional pages as needed. Yes No n <br /> To rezone Lot 1 Dane County Certified Survey Map Number 7622 to Two-Family Residential Zoning District. <br /> Existing Zoning Proposed Zoning iAcres <br /> District(s) . District(s) <br /> SFR-1 <br /> TFR-08 i1.492 <br /> Applications will not be accepted until the applicant has contacted the town and consulted with department staff <br /> . to determine that all necessary information has been provided. Only complete applications will be accepted. All <br /> information from the checklist below must be included. Note that additional application submittal <br /> requirements apply for commercial development proposals,or as may be required by the Zoning Administrator. <br /> I Scaled drawing of II Legal description 8 Information for I Pre-application I Application fee (non- <br /> proposed property of zoning commercial development consultation with town refundable), payable to <br /> boundaries boundaries (if applicable) and department staff the Dane County Treasurer <br /> I certify by my signature that all information provided with this application is true and correct to the best of my knowledge <br /> and understand that submittal of false or incorrect information may be grounds for denial. Permission is hereby granted for <br /> Department staff to access the property if necessary to collect information as part of the review of this application. Any <br /> agent signing below verifies that has the consent of the owner to file the application. - <br /> /' // �? Datel'i S - 9-1 <br /> Owner/Agent Signature C��RJt.C�'r <br />