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• DANE COUNTY Zoning Division <br /> PLANNING DEVELOPMENT Room 116, City-County Building <br /> 0,),=;•,, 210 Martin Luther King Jr. Blvd. <br /> �° _ Madison, Wisconsin 53703-3342 <br /> ,-. ,'. Change Application Phone: (608) 266-4266 <br /> w.!ts .g Zoning g pp Fax: (608) 267-1540 <br /> �., corgi _ <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 /> 0 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 K..t 6at_.vt .V\Cv- Agent's Name vK 1,.t i(1.14.€ <br /> Address -5-A5 3 C4--y, 4-Wy, I- ' Address &47'w e1i1k&vtO Trt V ' <br /> o5 ,b---77-1.6.00 Phone C‘03..) -5-77-1g00 <br /> Phone C mt.i( DAL. <br /> Email Email <br /> Town: 13'- J Parcel numbers affected: 001--//Z)./67 o2Fr "8-`.°Z1�o <br /> Property address or location: .rot f3 C 1j i f�-w y "P <br /> Section: 01 �� P dY <br /> Zoning District change: (To/From/#of acres) --'1 (rc, +0 r, 9'___114 fires <br /> A-I (Es) -0 1 -I 1¢ etc frle <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: _g_g__% Other: % <br /> 1 <br /> I <br /> i <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> O Separation of buildings from farmland <br /> Creation of a residential lot <br /> © Compliance for existing structures and/or land uses <br /> O Other: <br /> 11 <br /> I <br /> I <br /> I authorize that I am er or have p ission to a n half of the o er of the property. 0/ <br /> Submitted By: C/ <br /> t Date: . <br />