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DANE COUNTY Zoning Division <br /> PLANNING • DEVELOPMENT Room 116, City-County Building <br /> ° ' 210 Martin Luther King Jr. Blvd. <br /> l',_____ .: Madison, Wisconsin 53703-3342 <br /> 644- , Zoning Change Application Phone: (608) 266-4266 <br /> cg's Fax: (608) 267-1540 <br /> • <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 < Agent's Name <br /> Address Z/063S Qcrrcy4wgktLLliwe_ Address <br /> Phone R 4.14.(6,4(4 c.p,n4v, , S-3 ) Phone , <br /> 1006 , b f.4 © b4? Email <br /> Email d, tc,w <br /> aYfjY�QV�� CUG+�• S�e <br /> Town: OtP ►r <br /> i, ∎ Parcel numbers affected: °C© 9 - 0 r14— oo 1 0 <br /> Section: 01 Property address or location:60O (�_ )4 ` b vinev.itAi i ' <br /> Zoning District change: (To/From /#of acres) <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other: % <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> O Separation of buildings from farmland <br /> © Creation of a residential lot <br /> © Compliance for existing structures and/or land uses <br /> 0 Other: f <br /> ( rea / 0 L (DrSkfe '`o IRK. refQ 'i` c.d <br /> it <br /> I authorize that I am the owner or have permission to act on behalf of the owner of the property. _ ^ l4 <br /> Submitted By: • Date: <br /> < . - - .amt,..- - <br />