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DANE COUNTY Zoning Division <br /> ,-- ` PLANNING DEVELOPMENT Room 116, City-County Building <br /> (41E i `F 210 Martin Luther King Jr. Blvd. <br /> co,s,t Zoning Chan ge Application Madison, Wisconsin 53703-3342 <br /> Phone: (608> 266-4266 Fax: (608) 267-1540 <br /> Items that must be submitted with your application: <br /> o Written Legal Description of the proposed Zoning Boundaries <br /> Legal description of the land that is proposed to be changed. The description may be a lot in a plat, <br /> Certified Survey Map, or an exact metes and bounds description. A separate legal description is <br /> required for each zoning district proposed. The description shall include the area in acres or square <br /> feet. <br /> Scaled Drawing of the location of the proposed Zoning Boundaries <br /> The drawing shall include the existing and proposed zoning boundaries of the property. All existing <br /> buildings shall be shown on the drawing. The drawing shall include the area in acres or square feet. <br /> Owner's Name Nornj9s if Co�7NtE LAn1 e6 Agent's Name <br /> Address Ala/3Go <SHAmkocx Ro Address <br /> Phone �' o D t , Phone <br /> (.0S- a•1 ),-81$ 1 <br /> Email -1- J. / Email <br /> ¢.Held s. onl O l 45. ritr <br /> Town: Oa-A-e_ Parcel numbers affected: 0 9 0 S- 02-a 0 0 <br /> Section: 01 Property address Co r location: Ca,s4-- -7(s,--10/ OLP- <br /> Soil Cam- `f <br /> Zoning District change: (To/From/#of acres) CV t i A - (b X classifications of area (percentages) Class I soils: % Class II soils: % Other: % <br /> lC)c J / 6\/ <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> ® Separation of buildings from farmland <br /> © Creation of a residential lot <br /> • Compliance for existing structures and/or land uses <br /> O Other: <br /> I authorize that I am the owner or hay- •-rmission to act on behalf of the owner of the property. <br /> Submitted By:— Aitirh.' Date: c S <br /> DTt, <br />