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DANE COUNTY Zoning Division <br /> PLANNING <br /> IvLOIoII'~IY Room 116, City-County Building <br /> 210 Martin Luther King Jr. Blvd. <br /> Madison, Wisconsin 53703-3342 <br /> Zoning Change Application Phone: (608) 266-4266 <br /> 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. �I <br /> Owner's Name LY10. A i 0(\\, \pr Agent's Name <br /> Address '7 9 GtJl\pnE o©..8 Address <br /> Phone ""' ^ 841 3- 15 +^ Phone <br /> Email Email <br /> Town. CF Q1141 A Parcel numbers affected: ("Jae/0610 -/!n/_$OO <br /> Section: 01 Property address or location: 39761 [ lapkc � -o,� <br /> Zoning District change: (To/From/#of acres)1v -1 c I Ti no ly1 11' ��J <br /> Soil classifications of area (percentages) Class I soils: a % Class Il soils: SO % Other: % <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) 1, <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 /> ® ,Qther:Ke_,2of -ra be_(kb c rM eno bcc, lat <br /> I authorize that I am th. ow -r or -ye perm.--'• to on b�-half of the owner of the property. // /�(— <br /> Submitted By: I 4/ Date: O( o`J <br /> As :. t A tam.. <br />