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4 a <br /> REZONE PETITION # c,Z98 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 /> oo FLOOD PLAIN <br /> op WETLANDS <br /> ,moo SHORELAND - Body of Water <br /> ',Jo WELLHEAD PROTECTION AREA <br /> 1.30 DANE COUNTY REGIONAL AIRPORT HEIGHT <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 /> ±-2_0_. DEP 4( ,' <br /> °_ P C e—i.-- <br /> F S Co E_X1L I—Le to <br />