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DANE COUNTY Zoning Division
<br /> PLANNING DEVELOPMENT Room 116, City-County Building
<br /> a . 1 210 Martin Luther King Jr. Blvd.
<br /> r‘,A e ..�-- Madison, Wisconsin 53703-3342
<br /> �ocsf Zoning Change Application Phone: (608) 266-4266
<br /> . CO O 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 t c1/4.,r,._Gjz Bc-NA 'N-c..:1--c Agent's Name
<br /> Address CA°S Sc--"eJ eJ \Z:, 0"-N`,' "`^ (-'-' Address
<br /> Phone
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<br /> Email o.r v �o. - G it c \ �acj , �o r� — Email t
<br /> Town. Pte' ---4-- s Parcel numbers affected: 0 C 0 7— / `o Ll g0 ° U `,
<br /> Section: 01 I Co Property address or location: 1 C9 P c-�w.-(-Js Cam,-.--s-e,r \Z`.) 3elIu11\e,
<br /> .1 as aC f6_Zoning District change: (To/ From/#of acres) _ii D.. J R ' . , .1
<br /> Nrsom . aino�nn - - = GC C
<br /> Soil classifications of area (percentages) Class I soils: % Flass Ilsoils: % Other:
<br /> see , o, *( ,
<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:
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<br /> I authorize that I am the/40er. .- e •rmissi•r4 t i. ton behalf of the owner of the property. 12_1224 i if
<br /> Submitted By: � � g. I/ Date:
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