Extraterritorial Review Application

Date Submitted

Type of Submittal

Please Check One

Certified Survey Map
Preliminary Plat
Final Plat

Contacts

Zoning and Planning Department
Contact: Village Planner
Phone: (262) 363-6420
Fax: (262) 363-6425
Email: planner@villageofmukwonago.com

Guidelines

The undersigned petition is to consider a request, as stated herein, for the specified parcel(s) of land and will be reviewed by the Plan Commission and Village Board of the Village of Mukwonago. The application packet must be filed with the Village Clerk at least 30 days prior to the meeting of the Planning Commission at which action is desired.

Materials listed below must be provided to the Village of Mukwonago in accordance with Village Municipal Code Chapter 45 Article IV and other pertinent sections of Village ordinances, WI Stats. 236.34, and, as necessary, to permit review that is consistent with proper planning practice. The Village will strive to accommodate reasonable requests for informal preliminary staff review, however the Village shall not place any items on the agenda for Plan Commission consideration until such time as the application is complete in accordance with all requirements specified on this and other attached application forms.

Complete, accurate and specific information must be entered.

Applicant Information

(Full Legal Name)

Name

First Middle Last

Company

Name

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Applicant Email

Applicant is Represented by

(Full Legal Name)

Name

First Last

Company

Name

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Representative Email

Architect

Name

First Last

Company

Name

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Email

Professional Engineer

Name

First Last

Company

Name

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Email

Registered Surveyor

Name

First Last

Company

Name

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Email

Contractor

Name

First Last

Company

Name

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Email

Property and Project Information

Property Owner(s) (if different from applicant):

Address

Street Address Address Line 2 City State ZIP Code

Daytime Phone

Fax

Email

Location/Address

Present Zoning

Tax Key #(s)

Name of Town Property is Located In:

Town Official Contact Name:

Town Official Phone #:

Email

Present Use

Intended Use

Procedural Checklist for Extraterritorial Review and Approval

The application packet must be filed with the Village Clerk at least 30 days prior to the meeting of the Planning Commission at which action is desired.

Certified Survey Maps shall be prepared as provided in § 236.34 (1m) (c) Wis. Stats. and Article IV of the Land Division Ordinance. Submittals for review must include and be accompanied by the following:

Application:

Completed application form including the procedural checklist.
Application fee: $200
Agreement for Reimbursable Services (separate application)

Certification

Applicant hereby certifies that:

All of the above statements and other information submitted as part of this application are true and correct to the best of his or her knowledge.
Affirms that no Village of Mukwonago elected or appointed official or employee has a proprietary interest in the above referenced property for which this applications being filed (except as stated below under “Exceptions”).
None of the above referenced individuals has been promised or given any contract for consultation, planning or construction in relation to this project (except as stated below under “Exceptions”).
Applicant has read and understands all information in this packet.

Applicant further understands the policies of the Village regarding change of zonings and property development. Conditions of the resolution regarding all approvals are strictly followed. Certificates of Occupancy are not given until all conditions of approval have been met. .

By the execution of this application, applicant hereby authorizes the Village of Mukwonago or its agents to enter upon the property during the hours of 7:00 am to 7:00 pm daily for the purpose of inspection. Applicant grants this authorization to enter even if this land has been posted against trespassing pursuant to Section 943.13 WI Stats.

(The applicant’s signature must be from a Managing Member if the business is an LLC, or from the President or Vice President if the business is a corporation. A signed applicant’s authorization letter may be provided in lieu of the applicant’s signature below, and a signed property owner’s authorization letter may be provided in lieu of the property owner’s signature[s] below. If more than one, all of the owners of the property must sign this Application).

Property Owner Signature

Property Owner Name

First Last Title

Applicant Signature

Applicant Name

First Last Title