TOWN OF VIENNA

PLAN COMMISSION APPLICATION

REZONE / CONDITIONAL USE PERMIT / VARIANCE / LAND DIVISION / SPECIAL EXCEPTION PERMIT

Contact Person:
 
 Telephone Number:
SECTION A - GENERAL INFORMATION
Date of Application:  
Applicant's Name:

 Address:
Home Telephone:

 Work Telephone: Fax:
Owner's Name
(if different than applicant):


 Address: Telephone:
I, ________________________________________, authorize and agree to submitting this application pertaining to land that I own in the Township of Vienna, County of Dane, State of Wisconsin.

__________________________________
(Owner's Name)

 

___________________________________
(Applicant's Name)



___________________________________
Date Signature of Owner
Agent Name:

 Address: Telephone:
SECTION B - PROPERTY DESCRIPTION AND INFORMATION
Section:
  1/4   1/4 Section:
 Parcel number:
32-0909- __ __ __ -__ __ __ __- __
Parcel Address:
 
  Total Acres in Parcel: Total acres to
be rezoned:
Present Zoning:
  Requested Zoning:
Intent or Purpose:

______________________________________________

______________________________________________

______________________________________________

______________________________________________

______________________________________________

______________________________________________

Is there a house built on this parcel now? Yes    No

Have you previously submitted an application for rezone on this parcel? Yes   No

Is this the original tract of land owned before December 10, 1974? Yes   No

Has the property been previously rezoned? Yes    No

If yes, how many times? 1  2  3

Are there any deed restrictions on this property? Yes   No

Explain land divisions, provide dates and attach documentation.
Have you notified landowners within 1/4 mile of your intent?  Yes   No

Have you filled out an application with Dane County?   Yes   No

<
PART C -
CONDITIONAL USE PERMIT (CUP), VARIANCE AND/OR SPECIAL EXCEPTION PERMIT
Are you requesting a: CUP Variance Special Exception Permit

If yes, please explain: ________________________________________________________________
________________________________________________________________

________________________________________________________________


Intent or purpose:
_________________________________________________________________
_________________________________________________________________

_________________________________________________________________
SECTION D - LAND DIVISION
The division of this parcel(s) will create how many lots, parcels or building sites?

1  2  3  4

SECTION E - SITE VISIT
Do you have an objection to a site visit by Plan Commission or Town Board members with reasonable notice?

Yes   No
SECTION F - APPLICANT'S STATEMENT
All of the information on this form is accurate.

_________________________________________________________________
Date Signature of Applicant
SECTION G - ADDITIONAL REQUIREMENTS
Before your request will be placed on the Plan Commission agenda for consideration:
  • This form must be filled out completely, with any necessary attachments.
  • A site plan must be submitted with the application.

  • A $25.00 application fee must be made, payable to the "Town of Vienna" when you submit this application to the Clerk/Treasurer.
  • Land division fee of $15.00 plus $2.00 per lot (if applicable).
  • A rezone request for land zoned A1-EX, must include an aerial photo with the property highlighted and must be submitted with the application. A photo for this purpose can be obtained from the Clerk/Treasurer.

The following form was provided with this application, and must be completed and submitted to the Clerk/Treasurer prior to approval of your Preliminary Certified Survey Map:
  • Driveway Placement Form,
    signed by the Town Chairman