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415 <br /> REZONE PETITION # 6,43(a 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 /> 1,30 FLOOD PLAIN <br /> o o WETLANDS <br /> 00 SHORELAND - Body of Water <br /> 130 WELLHEAD PROTECTION AREA <br /> ,.)o DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> po HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area ( s ) ; list <br /> pertinent information and questions . <br /> yES— D . E . D . <br /> Co . EXEC . h1Er ( C7 <br /> CoP/ <br /> ✓ N-tAP ✓ p <br />