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REZONE PETITION # (eV/Go 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 /> y aS FLOOD PLAIN <br /> E' 300± ` 1 r -0posed r-e30 .� e, 0. ,..-e � <br /> y E5 WETLANDS <br /> yEs SHORELAND ) Body of Water I -ee ;A-ate �. S+-Yea -- <br /> 00 WELLHEAD PROTECTION AREA C ,-lct <br /> 00 DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> 00 HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> 'ES Dec) <br /> Y�5 F P G-e, E- <br /> U <br /> CKec f--{-ec,KU <br />