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REZONE PETITION # (P5i(, 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 /> FLOOD PLAIN <br /> ',50 WETLANDS <br /> N0 SHORELAND - Body of Water <br /> No WELLHEAD PROTECTION AREA <br /> ,,40. DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> Qo HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area ( s ) ; list <br /> pertinent information and questions . <br /> No E. o . <br /> `/E-- s — Go XEG . r1E�to <br /> N F p LoPY <br /> L. � . <br /> MQ p <br />