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DANE COUNTY Zoning Division <br /> PLANNING DEVELOPMENT Room 116, City-County Building <br /> ' i <br /> tc- . <br /> 'k` 210 Martin Luther King Jr. Blvd. <br /> Madison, Wisconsin 53703-3342 <br /> * Zoning Change Application 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 /> buildings shall be shown on the drawing. The drawing shall include the rea in acres or square feet. <br /> Owner's Name T/j% l` ,IPj,k)j l L� t/4'- Agent's Name • 641 ��"/"g. <br /> Address I �*k 1 �/\ 66/2-6 FAI Address 4'00115./ '`G iN 0 UA b At <br /> 6,6-16-- G/24-No IV�i U Pi-- U rte' s.Q.l u� <br /> Phone M jyDN/ // 3 Phone �S���v <br /> Email �d F!4-G-a 6.47g0`A Email 14-CQ/11(0 S rb s_ ,kJ 7 <br /> Town-C'bi5 /114414 Parcel numbers affected: D 207"ly('-C7 -0 6707 li) 8 310 -0 <br /> Q 2— (j cp0 PGA`-Pu <br /> Section: 01 1 1 Property address or location: -t /Vlfk) 4 <br /> Zoning District change: (To/From/#of acres) /1'--j >��� ghl--- 3 <br /> Soil classifications of area (percentages) Class I soils: 0 % Class II soils: 50 % Other: ` : <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> O Separation of buildings from farmland <br /> B Creation of a residential lot <br /> O Compliance for existing structures and/or land uses <br /> • Other: f I� <br />• No Mgui Rq6, J2i,6P-r- <br /> I authorize that I am the owner or ha ion to act on b alf.f the own: • the . .perty. <br /> Submitted By: /ti / / Date: //` <br />