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Dane County Rezone & Application Date Petition Number <br /> 05/15/2013 DCPREZ-2013-10568 <br /> Conditional Use Permit Public Hearing Date C.U.P. Number <br /> 07/23/2013 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> DEBORAH M DUCKART Code) DAN BIRRENKOTT Code) <br /> (608) 837-7425 (608) 837-7463 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 2916 PEBBLE VALLEY CT P.O. BOX 237 <br /> (City,State,Zip) (City,State,Zip) <br /> SUN PRAIRIE, WI 53590 SUN PRAIRIE, WI 53590 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> DEBSKI008 @GMAI L.COM DBI RREN KOTT @BI RRENKOTTSURVEYI NG.COM <br /> ADDRESS/LOCATION 1 ADDRESS/LOCATION 2 ADDRESS/LOCATION 3 <br /> ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP <br /> 3315 NELSON ROAD NELSON RD <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> BURKE 24 BURKE 24 <br /> PAR J c IIPf1►titt. 4 PA1 iNUMSERl�il)r f V!D ''P HUM INVOLVED <br /> 0810-243-8000-4 0810-243-8030-8 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> ZONING COMPLIANCE FOR STRUCTURES <br /> i FR0m Tr. I xr,P. nsTR e:::Oic ":� >s y rt tW o + [[+0 . .. <br /> C-1 Commercial District A-1 Agriculture District 3 <br /> C-1 Commercial District RH-1 Rural Homes 2 <br /> District <br /> C-1 Commercial District R-1 Residence District .75 <br /> C-1 Commercial District R-1A Residence District 1 <br /> C-1 Commercial District A-1 Agriculture District 2 <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTORS INITIALS SIGNATURE:(Owner or Agent) <br /> REQUIRED? <br /> ❑ Yes ® No ® Yes ❑ No ❑ Yes ® No 1 / K('I,�- <br /> AMA1 <br /> Applicant Initials kit Applicant Initials ,(Ytr Applicant Initials �/ PRINT NAME: <br /> De lerlt-r it 1`'M• Jlrc)412-' <br /> CSM/DOC#: DATE: <br /> DEED RESTRICTION: <br /> DEED NOT: 72/24/ /S 20/3 <br /> OTHER: plat: %201)11 <br /> Form Version 03.00.02 <br />