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DANE COUNTY <br /> PLANNING Zoning Division <br /> .r., DEVELOPMENT Room 116, City-County Building <br /> *VI 210 Martin Luther King Jr. Blvd. <br /> Madison,Wisconsin 53703-3342 <br /> Zoning Change Application <br /> Phone: (608) 266-4266 <br /> g g Fax: (608) 267-1540 <br /> Items that must be submitted with pp <br /> our application: <br /> Y <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 <br /> I Pio, .S i/Vt („/x 1 i&rk/ Agent's Name <br /> Address 4410 7 t./, /As fife- K'' � �2> Address <br /> Phone CAL,a--'133-.3 d 3 <br /> Phone <br /> Email Q Email 10,^% . 20Nrv4n11✓,I LOS, <br /> trG'".` <br /> Town.(o 1-1/95e. td✓`e— Parcel numbers affected: <br /> Section: 01 Property address or location: <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 /> © Separation of buildings from farmland <br /> O Creation of a residential lot <br /> O Compliance for existing structures and/or land uses <br /> O Other: <br /> I authorize that I am i- ... .:ve p i. t. on behalf of the owner of the property. <br /> Date: /�— �1 <br /> Submitted By: 2� <br />