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4- I z_ <br /> REZONE PETITION # C5Ei 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 /> 12-S -f o rA� Ac_eES <br /> 1.1 o FLOOD PLAIN <br /> 1,i 0 WETLANDS <br /> e, SHORELAND - Body of Water -FL-4- -e {-e s ca i 1-e.- <br /> b. .� ea ''`fi� b�f-c_� <br /> TECTION AREA ' �'iac(c. Eo <br /> � o WELLHEAD PRO t c n Le 4--1, 3oa p op +L e_ <br /> ti rZ c,c -rte;s r c-e i . <br /> /..)° DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> No HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area ( s ) ; list <br /> pertinent information and questions . <br /> yes p E.D . <br /> yam— Go . <br /> • <br /> y i_ 5 F P LopY <br /> L• D ° <br /> SAP p <br />