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• <br /> zs <br /> REZONE PETITION # (A-73 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 /> �(PO <br /> -TOTAL_ Ac ee. <br /> /00 FLOOD PLAIN <br /> WETLANDS <br /> SHORELAND - Body of Water <br /> t_t o WELLHEAD PROTECTION AREA <br /> i.40 DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> oo HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> NI E5 C-0 . )(E.G . t %a.friO <br /> D . <br /> 1-'A A P ✓ ' ID <br />