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DANE COUNTY Zoning Division <br /> gam, ` LO�'M E T Room 116, City-County Building <br /> 'c),,-,42,,o ,°a"g:, 210 Martin Luther King Jr. Blvd. <br /> F Madison, Wisconsin 53703-3342 <br /> t <br /> "' Zoning Change Application Phone: (608) 266-4266 <br /> -,;,�c j, 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' Name (/(Ji/VQS&Q. ,L TAB g IL Dent's Name � ,^ Q• Gviza 1.41,v,,,x <br /> rv#or Aim,tia te.,,,e.-, sczLI+ n , LA- p <br /> Address -7 0 N oQ-t-1r1 rv,&%N sT. Address G:25 • 4 %./".15-12-• `J? ` c k.„f \ <br /> (P <br /> Phone Phone <br /> CI 20 • 510 3 . 6421 o X 361 6 <br /> �Errn \� /c� <br /> Email R�3ufl�-oN6e LBAN\ONII% P�Lttw1Ert. . L c.Y^�c)Tl•Ww�wrlc esq.O'hAVwibN -Zap <br /> Town. W•nflgoe- Parcel numbers affected: C.‘,605 - 1 <br /> Section: 01 3I Property address or location: Ne•T1.4 of - 45 O42 L,a`4.» "(A-*- <br /> 4OTj ' <br /> Zoning District change: (To/ From/#of acres) - O C t / C 2 ppa-i- of Leer 2 r <br /> tic,vie, 1 45 (h&' o3 1.,/ c <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other:_ Vo <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 /> ® Compliance for existing structures and/or land uses <br /> O Other: <br /> I authorize that I arrtthe owner or have p misy act on behalf of the owner of the property. / 'L S" 7;—S---. <br /> Submitted By: , Date: <br /> 1 <br /> A <br />