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O''''. <br /> Dane County Application Fees <br /> :'pT� Department of Planning and DevelopmentIMMEM $395 <br /> I 01.-', --'` �`i Zoning Division Farmland Preservation: $495 <br /> r, j.: Room 116,City-County Building Commercial: $545 <br /> 210 Martin Luther King Jr.Blvd. • PERMIT FEES DOUBLE FOR VIOLATIONS. <br /> SCor—"" 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: Karen&Aaron Carlock Agent Name: Williamson Surveying and Assoc. LLC <br /> Address(Number&Street): 4374 State Highway"78" Address(Number&Street): 104 A. West Main Street <br /> Address(City,State,Zip): Black Earth,WI 53515 Address(City,stale,Zip): Waunakee, WI 53597 <br /> Emil Address: karen.carlock©gmail.com 01 gotAddress: Chris@williamsonsurveying.com <br /> Phones: 1-773-682-8599 Phone#: A 1-608-255-5705 <br /> WI <br /> PR irINFORMATION """' ' <br /> Township: Vermont Parcel Number(s): 060/0706-052-9501-0 and 060/0706-052-9300-0 <br /> Section: 5 Property Address or Location: 4710 Cedar Hill Lane, Black Earth,WI 53515 <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. Yesn No 1!1 <br /> The Carlock's are selling a 9.27 acre Lot to a family member so they can build a house on the southern side of the property. <br /> Existing Zoning Proposed Zoning Acres <br /> District(s) District(s) <br /> I FP-35 FP-1 8.19 <br /> FP-35 RR-1 1.08 <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 /> ®Scaled drawing of ®Legal description 0 Information for 0 Pre-application ❑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 /> l 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 tha e •-- as the c�t of the owner to file the application. <br /> Owner/Agent Signature Date _1S->),D- <br />