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REZONE PETITION # ( 3o) 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 /> FLOOD PLAIN Astoc- 1d <br /> WETLANDS <br /> SHORELAND - Body of Wateri� <br /> WELLHEAD PROTECTION AREA <br /> DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area ( s ) ; list <br /> pertinent information and questions . <br /> '/ES L ED <br /> p GP r 1- <br /> y�S c--0 �c r--( wt 0 <br />