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• <br /> REZONE PETITION #, 6655 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 /> 0.43 -rc;At_ Ac 5 <br /> ;,D0 FLOOD PLAIN <br /> oo WETLANDS <br /> SHORELAND - Body of Water <br /> 1,40 WELLHEAD PROTECTION AREA <br /> YES DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> o HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> 1JO p. r . D <br /> c.o . a.x E'- . M a r-tc <br /> �►U F P LGPY <br /> L. p . ✓ ' D <br /> A«P ✓ D <br />