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4/8 <br /> REZONE PETITION # (,495 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 /> KD o FLOOD PLAIN <br /> • <br /> 00 WETLANDS <br /> 00 SHORELAND - Body of Water <br /> 1`10 WELLHEAD PROTECTION AREA <br /> 1,4 ° 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 /> `/E5 D. c .o. <br /> La. cxGG. MEMO <br /> yes F P LoPy <br /> L . 0 . ✓ <br /> MAP ✓ <br />