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REZONE PETITION # C,195 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 /> r�o FLOOD PLAIN <br /> 00 WETLANDS <br /> oo SHORELAND - Body of Water <br /> No WELLHEAD PROTECTION AREA <br /> oo DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> oo HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> N 0 Tf 2-e 5 Lib,t ; 1-1-a t o 2{3a-v'-2 <br /> ��5 b E rD CP 0 CP Z - C F-t, moo <br /> y� 5 ✓ eco -ded <br /> FP <br /> yG5 C0 E Xe� ego <br />