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Dane County Rezone & Application Date Petition Number <br /> 01/19/2016 DCPREZ-2016-10953 <br /> Conditional Use Permit Public Hearing Date C.U.P.Number <br /> 03/22/2016 _ <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> DON WAHLIN (DCW INVESTMENTS Code) Code) <br /> LLC) (608) 873-2525 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 2571 HAVEY LANE <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> donw @stoughtontrailers.com <br /> ADDRESS/LOCATION 1 ADDRESS/LOCATION 2 ADDRESS/LOCATION 3 <br /> ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP <br /> 2614 OLD STAGE RD <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> / RUTLAND 35 <br /> PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED <br /> 0510-351-8500-4 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> CREATE A SMALL AGRICULTURE LOT FOR HUNTING <br /> Novi of <br /> 352y ox-0 s Ica-Rom <br /> FROM DISTRICT: TO DISTRICT: ACRES DANE COUNTY CODE OF ORDINANCE SECTION °' ' ACRES <br /> A-1 Ex Exclusive Ag A-4 Agriculture District 23.6 <br /> District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S INITIALS SIGNATURE:(Owner or Agent) <br /> REQUIRED? <br /> • <br /> ® Yes ❑ No ❑ Yes ® No ❑ Yes II No , 0-4.. C � <br /> SSA1 � <br /> Applicant Initials Applicant Initials O- Applicant Initials LW) PRINT NAME: <br /> V 0 14 (JA/a L 1/1 <br /> DATE: <br /> (i-2.o- Zvi/ <br /> CSM/DOC#: tHa53/5,D 3R'16a <br /> DEED RESTRICTION: Form Version 03.00.03 <br /> DEED NOTICE: <br /> OTHER: <br />