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DAME COUNTY Zoning Division <br /> PLANNING DEVELOPMENT Room 116, City-County Building <br /> c.?. ;. 210 Martin Luther King Jr. Blvd. <br /> Madison, Wisconsin 53703-3342 <br /> .1 - Zoning Change Application Phone: (608) 266-4266 <br /> �COr'S'' 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 /> o 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 y,+di:tel I ! c VA/146,141 Agent's Name tz D � <br /> Address (O4 jet. . se1 �L/`t.: Address Jo t7C.MC7 3 I ] C�'j/ % 'citi(� <br /> Phone 1/9-�,'lli144 , � ' -�',913 Phone Z ; .S.C7 9 <br /> Email Email '21. - ! 4 0 <br /> Town: Parcel numbers affected: (-009 364 - ``/ 4 71 t)-)C <br /> I <br /> Section: 01 Property address or location: /� <br /> Zoning District change: (To/From/#of acres) -5- / ,4)-J-6) <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other:_ % <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> O Separation of buildings from farmland <br /> O Creation of a residential lot <br /> O Compliance for existing structures and/or land uses <br /> O Other: <br /> iig.,'*-t t;lki,iAA, L5t 52 6 G i?l5 viol- e A "I <br /> i <br /> I <br /> r. <br /> I authorize that I am the owner or �4ier i-sion to act on behalf of the owner of the property. �® <br /> Submitted By: 4 Date: - <br />