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zo <br /> REZONE PETITION # Lv_ 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 /> I-40 FLOOD PLAIN <br /> No WETLANDS <br /> Po55. <br /> AWL_ SHORELAND - Body of Water I �� Ift <br /> 1 v i 4--c -4 c� t-4 L.tc1 G C C k- <br /> 1-�c, WELLHEAD PROTECTION AREA -Ct o..a s PP�—o c t y oo <br /> L ). o(2 +4 ; s <br /> DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> -_ 20 HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> YES , p. E. D . <br /> 4 Go , EXEC • ME�-t0 <br /> Nv FP Lo�Y <br /> LD . <br /> 1-AA P '� D <br />