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1. 8• <br /> REZONE PETITION # (4/ o5 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 /> 1.10 FLOOD PLAIN <br /> Ho WETLANDS <br /> N p SHORELAND - Body of Water <br /> 1-40 WELLHEAD PROTECTION AREA <br /> 1,40 DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> 100 HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> Y ES p. c>. <br /> Lo MEt-tO <br /> yG5 FP GoPY <br /> L . 0 - • C <br /> MAP ✓ P <br />