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II <br /> DAME COUNTY Zoning Division 1 <br /> PLANNING DEVELOPMENT Room 116, City-County Building jl1 <br /> rIgi VW', 210 Martin Luther King Jr. Blvd P <br /> o° t'. Madison, Wisconsin 53703-3342 <br /> `, t - :' Zoning Change Application Phone: (608) 266-4266 <br /> CO s 4 Fax: (608) 267-1540 <br /> 1 <br /> Items that must be submitted with your application: <br /> il I!I <br /> 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 Ii <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 a VI Agent's Name <br /> Address (-7d 1(.,J `I Address <br /> Phone 1 (`1 `C-t f C'"1 53G0 Phone <br /> C-e041 b 0 Merl: Ceel.■ <br /> Email Email t)01 CIV- <br /> Town: ;RV 4 A Parcel numbers affected: 09 0 7 ( •7 S $a 3Q ( <br /> Section: 01 r7 Property address or i location: 44A t, C1170 c'(-. `4 a y y' <br /> Zoning District change: (To/ From/#of acres) g(-( 3 ( 4- I £)( /a. tic re I <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 /> G Creation of a residential lot <br /> O Compliance for existing structures and/or land uses <br /> 0 Other: <br /> I 104 Csm <br /> I authorize that I am t - • ner or have p:r ssion to act on behalf of the owner of the property. <br /> Submitted By I a-) ,IH Date: <br />