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4" <br /> REZONE PETITION # 6,427- CONDITIONAL USE PERMIT # <br /> N <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 /> PAZ--r FLOOD PLAIN g S S o c c_Le d 4-(ti l T ;oc -arc e r vE 2 <br /> Oo WETLANDS <br /> ,Do SHORELAND - Body of Water <br /> No WELLHEAD PROTECTION AREA <br /> No DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> oo HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> "/-es p. E . o . <br /> S Co . EXEC, HEM ° <br /> FP. Copy <br />