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* 3 <br /> REZONE PETITION # L,554 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 /> o L. E� <br /> FLOOD PLAIN <br /> WETLANDS <br /> .460 SHORELAND - Body of Water <br /> No WELLHEAD PROTECTION AREA <br /> No DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> pa HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> E5 D. Q . D . <br /> r-tG <br /> -/Es FP LA Y <br /> ,� L. D . <br />