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REZONE PETITION # 6,5,4 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 /> i_10 WETLANDS <br /> SHORELAND - Body of Water <br /> No WELLHEAD PROTECTION AREA <br /> i�o DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> too HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> r�lO D . e .P . <br /> EXEC . r-tE <br /> (-10 r P cc.)Py <br />