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8 <br /> REZONE PETITION # 64E4, 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 /> pA 2 T FLOOD PLAIN a-101-4.1 S t-t o r <br /> 00 WETLANDS <br /> E S SHORELAND - Body of Water L_o.k e._ A ; e 4- <br /> 1_10 WELLHEAD PROTECTION AREA <br /> til0 DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> 0 HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> p. c .�. <br /> MEr-i0 <br /> r{2. FP GoPY <br /> L . D . ✓ ' D <br /> MAP ■ <br />