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48 <br /> REZONE PETITION # Co”j CONDITIONAL USE PERMIT # / ; U <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 /> 63.0 -To-r4 . Ac.ae5 <br /> o FLOOD PLAIN <br /> A)0 WETLANDS <br /> do SHORELAND - Body of Water <br /> r, o WELLHEAD PROTECTION AREA <br /> f,D o DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> po HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> S Go . EXEC . r1Et-to <br /> F p GAD 4:;"/ <br /> MAP ✓ ' � <br />