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c/ <br /> DANE COUNTY <br /> SPECIAL EXCEPTION PERMIT # ( •7( I <br /> The undersigned hereby applies for a special exception permit as required by <br /> Section 11.05 (3) of the Dane County Code of Ordinances. <br /> PUBLIC HEARING DATE M 1. Z8) F ,.k <br /> PROPERTY ADDRESS dCe a t-f -aka aAct p <br /> 1� �,, l / � to ,21 <br /> TOWN vv'r g'` DIV-(- SECTION 22 1/4 1/4 1-16trichkS Pcl // <br /> SUBDIVISION Man{ Lake) gta !Jl}1'I PAM CSM ft LOT BLK <br /> BODY QF WATER D t K �`'t.(^e C(���C / 141/1-(4-6(-vvL(d C�Ptt/L A-ag2 1,`)Q1 -1-Y/ (01/t11-0 N �-0 La l�- <br /> AA4°Ti p YQ (ALA)?C( tR(`Ve�';Cf LA U.. ticic,cderfav <br /> FLOOD ZONE y WETLAND' PERMIT NUMBER/S <br /> PURPOSE FOR WHICH THE WORK IS INTENDED <br /> (1 W°V ,L&k OD1(SSYU Ghd L/C •wc� tt� I <br /> OWNER: Oc ) \ 04- W PS7 e0 AGENT: V/a /AU 0/j 'uS� <br /> f'er At <br /> —row IJJe.sf /Io�"�' y ►" ICijn rfo <br /> u.d- ` (a4. I2r1, &o 6 rc( . 5 1ov1/19r <br /> t,Ucu���K�e ��>i, S3��i Olactcso�, L4Jr 37( <br /> Phone F oi — 43 (7 2_ Phone 833-C96.28 <br /> Date 13 F % C)(Pi <br /> +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ <br /> ACTION BY THE DANE COUNTY BOARD OF ADJUSTMENT <br /> GRANTED DENIED DATE <br /> CONDITIONS OR SPECIAL INSTRUCTIONS ARE LISTED ON THE REVERSE SIDE OF THIS FORM Nad <br /> PAGE (1) <br /> 545-33 (6/90) (21) SPEC EX PMT <br />