NOTICE OF INTENT
To SUBDIVIDE

Request: A ZONING Change
and/or
BUILD A Structure

IN THE TOWN OF VIENNA

Name: ___________________________________________

Address: __________________________________________

Telephone: ( _______ )- ______________

• Purpose:



• Legal description of parcel in question:



• Attach map or sketch of parcel (professional, or scale drawing not necessary).

Please show:

• Road cuts
• Dimension of land (including proposed division(s), if applicable)
• Location of structures (well and septic systems if present)

• Type of action requested:

___ Land division

___ Zoning change request

___ Building permit

___ Other

Specify:_____________________________________

• Pay fee, if applicable $_______________
                                      (Amount)
  

• Miscellaneous information:

I (we) hereby acknowledge receipt of a copy of the Land Division and Subdivision Regulations Ordinances, Town of Vienna, Dane County, Wisconsin, and agree to pay for any professional assistance as provided for in 10.31 of the Ordinances. I (we) understand that the ordinance refers to minimum and maximum lot sizes, site layout, utilities, driveways, roads, landscaping, lighting, public areas, fees, professional land planner review, erosion control, and installation of all improvements as it applies to all building permits with the exception of non-residential buildings. I (we) also hereby acknowledge receipt of a copy of the Town's Land Use Plan.

I (we) agree to proceed in accordance with the Town's ordinances and plans.

Date: ________________, 200__

Signed: ________________________________________________

______________________________________________________________