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• <br /> REZONE PETITION # (, 99 CONDITIONAL USE PERMIT # <br /> • <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 /> '3 b,c_ae-s t ( ;A c,„I 1-1- •1 <br /> 1-De FLOOD PLAIN <br /> 00 WETLANDS • <br /> SHORELAND - Body of Water <br /> *7, Cve <br /> c. WELLHEAD PROTECTION AREA <br /> DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area ( s ) ; list <br /> pertinent information and questions . <br /> Co .D. a. 0 . <br /> x t-t k--Ac) <br /> • <br /> F p <br /> I-A AP <br />