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c <br /> REZONE PETITION # Z41 CONDITIONAL USE PERMIT # <br /> C.U. P. ONLY: Action is/is not requested at the <br /> Public Hearing. <br /> Date <br /> Place an "X" in the box if all or part of the <br /> proposed Rezone/C . U. P . area is affected by any of <br /> the districts below: <br /> No FLOOD PLAIN <br /> t.-i o WETLANDS <br /> N D SHORELAND - Body of Water <br /> doss WELLHEAD PROTECTION AREA <br /> ti►d DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> oa HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> -e �v . Cam( e - r'-4 -e <br /> FP (cry <br />