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. <br /> REZONE PETITION # (40.291 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 /> kDa FLOOD PLAIN <br /> 1:70 S 5 . WETLANDS ( l r 2 e s o u14-. .mac e V e <br /> \/ '7 SHORELAND - Body of Water I Y,,; 4 a I s <br /> 1.3 o WELLHEAD PROTECTION AREA b e y S -��; s Pau f <br /> S Ste ' <br /> po DANE COUNTY REGIONAL AIRPORT HEIGHT U <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 /> y- .p EP <br /> ye_S <br /> =5 C E wt-e .,1v <br /> d <br />