Agenda Request Form Planning

Town of Mukwonago W320 S8315 Beulah Road Mukwonago, WI 53149 www.TownOfMukwonago.us Phone (262)363-4555 Fax (262)363-8377 PLANNING AGENDA ITEM REQUEST FORM Requested Meeting Date REQUESTER INFORMATION Name Address Telephone/Cell Tax Key # E-mail NATURE OF BUSINESS TO BE DISCUSSED (please provide complete details) Attach additional sheets and supporting information as necessary. To appear as a specific item of business on the Town of Mukwonago’s Planning Commission/Town Board agenda, a complete and documented request must be received at the Town Planners office no later than 21 days prior to the meeting scheduled or requested. Business items on the agenda will be placed on a first come first serve basis. In the event of a full agenda, you will be placed on the next available agenda. Plan Commission meetings are held on the 1st Wednesday of every month. Meetings begin at 6:30pm and are held in the Town Hall Meeting Room. SUBMIT TO Ben Greenberg/Town Planner ben.greenberg@cedarcorp.com DEADLINE Applicants; please provide 12 copies of application materials 21 days prior to Plan Commission Meeting which is on the first Wednesday of the month. SIGNATURE DATE OF REQUEST FOR OFFICE USE ONLY Date Received Received by