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Rio <br /> REZONE PETITION # ( 53o 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 /> SZ,Z To-►-4 cee s <br /> uo FLOOD PLAIN <br /> Q0 WETLANDS <br /> po SHORELAND - Body of Water <br /> 1_10 WELLHEAD PROTECTION AREA <br /> 1_10 DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> ,moo HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area ( s ) ; list <br /> pertinent information and questions . <br /> YE5 p. E.D . <br /> `lam— Go . EXEC . MEND <br /> y E 5 F p Lo.1= Y <br /> 1-• o - <br /> MAP ✓ ' ID - <br />