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DANE COUNTY Zoning Division <br /> re a PLANNING-' : DEVELOPMENT Room 116, City-County Building <br /> 210 Martin Luther King Jr. Blvd. <br /> - ,,--.5 Q�,: Zoning Change Applicati <br /> ` Wisconsin 53703-3342 <br /> on Madison 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 /> I buildings shall be shown on the drawing. The drawing shall include the area in acres or square feet. <br /> I Owner's Name M Act J(4\5 j\ Agent's Name <br /> Address j 7(o(9 Nu\V(0'V50 V. V Address <br /> Phone ( ���-10 6� J 3) 5 l o`^�)k�01n ,1A)‘S1 j.351)9 Phone <br /> Email J kk5e lk,\ g `,ct1,,a) ,U" Email <br /> Town. i Y2 n Parcel numbers affected: © (Q © " a ?' - ,9',...3... 0 -6 <br /> v 7GCo 6\1 vt SO I ,lX <br /> Section: 01 Property address or location: <br /> Zoning District change: (To/From/#of acres) ,R - 1 �x 1,. b ,i" a ( I) <br /> Soil classifications of area (percentages) Class I soils: °/ C ss II soils: % Other: % <br /> sty A-1--fo,Q_In <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 /> scrCompliance for existing structures and/or land uses <br /> 8 Other: <br /> TO 13 v ?r0)'CrT' TO LC i1 CI ,iu0a ) Efroch0tt 1 <br /> ?Yo Qct 1"1 LiAc , <br /> I authorize that I am the ner or have permission to act on behalf of the owner of the property. /9 �� <br /> Submitted By: Date: // 7 <br />