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4 o <br /> • <br /> REZONE PETITION # (05-To 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 /> 41 - 7.0 74,_ Ac.EES <br /> es FLOOD PLAIN A s s o c i e d <br /> ( " ; s ►- p.'— -'- � ,d S -Lp,�, r <br /> o G IZ4 - ho d o��e C�3 . <br /> yes WETLANDS A-Z ( ?)) P� �� t 0.pp-ea. 5 -►-v b €_. A <br /> yES SHORELAND - Body of Water 1 4-e vt, G s I a <br /> l - I v l�x S LID c ✓ I'� ✓ P 6 h%0 WELLHEAD PROTECTION AREA -c( e s <br /> 300 4 v� C jQ< l i ,p- <br /> DANE COUNTY REGIONAL AIRPORT HEIGHT R I-I -z (�, ►zid 3 <br /> LIMITATION AREA pp � I , r-7- <br /> p0 HISTORIC OVERLAY DISTRICT (Indian Burial -11----,110,--, T- <br /> Mounds) � <br /> 4 -z ) r� .-c <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> Y�5 tom. . . <br /> . cXEL . M -.►"lG <br /> N F LoPY <br />