1OF3UPDATED1/3/2018
VillageofBrooklyn
ZoningorRezoningPermitApplication
210CommercialStreet,P.O.Box189
Brooklyn,WI53521
6084554201/fax4551385
clerk@brooklynwi.govordeputyclerk@br ooklynwi.gov
ZoningRezoning
ContactInformation
Name:
Co.Name(ifApplicable)
Address:
City/State/Zip
WorkPhone
HomeorCellPhone
Email Fax
BestWaytoreachmeis:
PhoneEmail
Iamthe:
OwnerTenantRepresentative
Procedure
NewRezoning
Pickupapplication.Readthroughexpectations.Ordinance(s)117303,117304,117544
MeetwithVillageofficials(zoninginspector)todiscussplanneduseandnecessarysubmittals. 
Completeapplicationandsubmitviapapercopyandsendapdfversionviaemailedtoclerk’s
office
21daysbeforePlanCommissionMeeting.
Clerktopublish,andnotifypropertyownerswithin300’andsetpublichearingdate.
AttendPlanC ommissionmeetingatwhichapplicationwillbeconsidered.
PlanCommissionpublichearingheld.Date:______________________________
ReferenceMaterialswww.brooklynwi.gov
VillageOrdinance(s)117303,117304,117544
ZoningMap
PropertyInformation
PropertyAddress:___________________________________________________________________
LotorBlock#:____________________________Subdivision:_________________________________
TaxParcel#:_____________________________TotalAcreage:_______________________________
CurrentUseofProperty:______________________________________________________________
ProposedUseofProperty:____________________________________________________________
ProposedRezoningNotApplicable
CurrentZoning:__________________________Current ConditionalUsePermitinPlace?_________
ProposedZoning:_________________________WillConditionalUsePermitbeneeded?_________
IfResidential:
NumberofDwellingUnits_____NumberofParkingStalls______
2OF3UPDATED1/3/2018
NonResidential:NumberofEmployees______NumberofParkingStalls______Handicapped_____
Hoursofoperation________
Submittals
Submit1papercopyandalsosubmitdocumentsviaemailinpdfformatthefollowingapplicableitemstothe
clerk@brooklynwi.govanddeputyclerk@ brooklynwi.gov

CertifiedSurveyMap,PlatorDrawingshowingthefollowing:
Lotsinvolved,locationsize,boundaries, dimensions,uses,andsizeofthesubjectsite;existing
proposedstructures;existingproposedeasements,streetsandotherpublicways;public
utilities;offstreetparking,loadingareasanddriveways;existinghighwayaccessrestrictions;
highwater;
channel,floodwayandfloodplainboundaries;steepslopes,woodedareas;and
existingandproposedstreet,side andrearyards.Inaddition,theplatofsurveyshallshowthe
location,elevation,anduseofanyabuttinglandsandtheirstructureswithin40feetofthe
subject.
Additionalinfomayberequiredby
thezoningadministrator,plancommission,villageboard,and
buildinginspector,villageengineering,fireandsafety,orpublicworks,andother
personnel/consultants,including allinformationrequiredforsiteplanapprovalunderOrdinance
117400.

Petitionsforchangeshalldescribethepremisestoberezoned:
Specifyinwritingadescriptionof
theproposedchange,reasonfortheamendmentandother
supportinginformationandattachthefollowing:
Aplotplandrawntoascaleofoneinchequals100feet,showingtheareaproposedtobe
rezoned,itslocation,itsdimensions,thelocationandclassificationofadjacentzoning
districtsandthelocation
andexistinguseofallpropertieswithin200feetofthearea
proposedtoberezoned.

LetterofIntent:
LetterofIntentshoulddescribe,indetail,whatthepropertywillbeusedfor.Includethe
purposefortherequest,constructionschedules,namesofpeopleinvolved(applicant,owner,
contractor,
architect,landscaper,businessmanager).Giveadetaileddescriptionofthetypeofbusiness
proposed,thehoursofoperation,numberofemployees,accessandparkingproperty.Ifresidential,
describehowmanydwellingunitsandexpectednumberofresidents,aswellasaccessandparkingon
property.
Includephysicalinformationon
thesizeandlayoutofthesite,aswellasanyfeaturesofthe
propertysuchaswetlands,floodplain,woodlandsorotherenvironmentalfeatures.
ThePlanCommissionisrequiredtobaseitsdecisiononwhethertheapplicantdemonstrated
thattheproposedzoningwillmeetthestandardsofthezoning
code.Includeanyadditional
informationthatyouwishtosubmitinsupport oftherequested action.
3OF3UPDATED1/3/2018
Owner’sSignatureStatementofUnderstanding
Bysigningbelow,I__________________________,certifythattheinformationcontainedinthisapplicati onis
trueandaccuratetothebestofmyknowledge,andunderstandthatadeliberatemisrepresentationof
informationmaybegroundsfordenialorreversalofthisapplication,and/orrevocationofanyapprovalalready
awardedbasedon
thisapplication.
IalsoauthorizetheVillageofBrooklynstaffpermissiontoviewandenterthesubjectpropertyforthepurposeof
reviewingandinvestigatingthisrequest.
Iunderstandthatthesubmittalofthisapplicationandpaymentoftheproperfeesdoesnotmeanthatissuance
ofaZoningchange
isimminentandguaranteed.
Iunderstandthatissuanceofazoningchangedoesnotqualifyas,norreplacethenecessityforproperpermitting
fortheproposedproject.
____________________________________________________________________
SignatureofApplicantDate
____________________________________________________________________
PrintedNameTitle
OfficeUseOnly
DateReceived:_________________By:____ ________________Parcel#:_____________________________
Referredto:________________________________________Fee:____________Check#________________
NotifyPropertyOwnerswithin300feet__________________Senton:___________By:________________
Publish/PostHearingNotice___________________________Senton:___________By:________________
OfficeUseOnlyMaterialsSentTo:
DateSent:ReturnBy:Response:
ZoningAdministrator_________________________________
BuildingInspector_________________________________
PublicWorks_________________________________
PoliceDepartment__________________________________
FireInspector__________________________________
EMS__________________________________
VillageAttorney(asneeded)________________________________ __
VillageEngineer(asneeded)__________________________________
Approvals
PlanCommissionmeetingdate:_________________________________
Yourrequesthasbeen:_____Approved_____NotApproved
_____ApprovedwiththeseConditions:
VillageBoardmeetingdate:____________________________________
Yourrequesthasbeen:_____Approved_____NotApproved
_____ApprovedwiththeseConditions:
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