TO:    Sussex Village Clerk

I (we), the undersigned, being the owner(s) of all the area herein described:

Hereby petition the Plan Commission and Village Board of the Village of Sussex, Wisconsin, to amend the Zoning Ordinance of the Village of Sussex.

(On a separate sheet/sheets attach any proposed Code language, reason for the same, and any additional information you want the Plan Commission and Village Board to consider.)

Due at Time of Submittal:  Application fee of $450. 

FOR OFFICE USE ONLY

Payment Received: __________________________________

Date Filed with Village Clerk: ___________________________

Public Hearing Date: __________________________________

Publish Dates:________________________________________

Plan Commission Recommendation:_______________________

Village Board Date: ____________________________________