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REZONE PETITION # CoZ9 Z 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 /> Qo FLOOD PLAIN <br /> No WETLANDS <br /> SHORELAND - Body of Water <br /> Po WELLHEAD PROTECTION AREA <br /> t..)o DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> PU HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> NO - DED <br /> Ov- <br /> 2 'd FR C,e— L-- <br /> yS Co E-7 e c_ ti-( e �.,� o <br />