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o <br /> • <br /> • <br /> REZONE PETITION # C'488 CONDITIONAL USE PERMIT # <br /> • <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 /> oo FLOOD PLAIN <br /> Imo WETLANDS <br /> pc' SHORELAND - Body of Water <br /> ,_i o WELLHEAD PROTECTION AREA <br /> i_to DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> o HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> yE 5 <br /> MEMO <br /> 1,4 c, FP C PY <br /> MAP ✓ P <br />