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• <br /> REZONE PETITION # 65oz. 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 /> 1-40 FLOOD PLAIN <br /> ,-4 o WETLANDS <br /> l-ro SHORELAND - Body of Water <br /> ,)o WELLHEAD PROTECTION AREA <br /> DANE COUNTY REGIONAL, AIRPORT HEIGHT <br /> LIMITATION AREA <br /> No HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> No pr . . <br /> Lo. cXGG. MEMO <br /> ■-■o F P CAP`f <br /> ✓' M A P ✓ L> <br />