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-z, <br /> REZONE PETITION # (p44� 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 /> 00 FLOOD PLAIN <br /> po WETLANDS <br /> 00 SHORELAND - Body of Water <br /> No WELLHEAD PROTECTION AREA <br /> 00 DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> 00 HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> -/ES <br /> yES c_o EC , MEa-ro <br /> copy <br /> 41> D <br />