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DANE COUNTY Zoning Division <br /> PLANNING DEVELOPMENT Room 116, City-County Building <br /> 210 Martin Luther King Jr. Blvd. <br /> Madison, Wisconsin 53703-3342 <br /> f Zoning Change Application Phone: (608) 266-4266 <br /> f 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 /> Agent's Name O m �o <br /> Owner's Name 1017/i OJ®bC IkI g <br /> Address SUS CAG�c.Jk 5 Rc\d en Address vn e <br /> Phone �r¢S} Phone <br /> (r 07- a a D-\f-1 <br /> I Email bCJ`Oe000 / hoo,cow. Email <br /> • <br /> Town: r 5}0 Parcel numbers affected: 00/06:17/ —°�a -q500 -- <br /> Section: 01 Property address or location: (oV s C. )dQ✓ Lao 1 iQ■f w 15 90 <br /> Zoning District change: (To/ From/#of acres) Gc�r r n+� �1Qtn° l►�� �� C. , <br /> 0 , 3(p(o acre27 <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other:_ % III <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 /> 9, Other: <br /> (7.5(\a n ,Y1 + v z r n i v\.--n ■-) PV-Q r C [Al i&n rt <br /> II <br /> I authorize that I am the owner or have permission to act on behalf of the owner of the property. <br /> Submitted By: Date: �I <br />