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Z <br /> REZONE PETITION # 647o 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 /> Po FLOOD PLAIN <br /> oo WETLANDS <br /> Cogs SHORELAND - Body of Water <br /> +1,-; b t Q -+v B :k- Ea-, iL <br /> 0 WELLHEAD PROTECTION AREA -----e-t - ` '�' `' 5�' e- <br /> w rtti LA.. 300 0C- S Lori ,," <br /> o 50 T - G. <br /> Ho 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 /> s D. E . O . <br /> . i-E 0 <br /> P ( 7 <br /> �.( i\a ✓ D <br />