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DANE COUNTY Zoning Division <br /> PLANNING, ' <br /> ' L N' NT.," E Room 116, City-County Building <br /> < r ga�1';1 210 Martin Luther King Jr. Blvd. <br /> ,r Madison, Wisconsin 53703-3342 <br /> , Zoning Change Application Phone: (608) 266-4266 <br /> aiv <br /> spa 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 I\\Act j05 Agent's Name <br /> Address 2) 7(G kA Vov50v• \'\ Address <br /> Phone (3o Lu' ,b' C.3) 5 Tow))6t•cOh ,10.5,5 3 9 ti Phone <br /> Email .)k 5t- k ® i cktr\W Email <br /> Town' l5 Y2 n Parcel numbers affected: O © " a 711 ^ r � -CD <br /> Section: 01 Property address or location: 3 ? (0 Nc-S o 4 , <br /> Zoning District change: (To/ From/#of acres) J'F ,It- a ( l ) <br /> Soil classifications of area (percentages) Class I soils: °/ C ss II soils: % Other. % <br /> See �-1 <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 /> I D Other: <br /> To o I3r' by ?roArTy TO Lo r ravi ce Eo''k"n it <br /> Li"( <br /> I authorize that I am the ner or have permission to act on behalf of the owner of the property. Date: 1/91/5-/ I J i/q f J Ci <br /> Submitted By: ,�./ <br />