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REZONE PETITION # (,(5,7Z, 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 /> po ; FLOOD PLAIN A 5 5 o C (c)-t-2 G c-o; c e {� <br /> uo WETLANDS <br /> y 5 SHORELAND - Body of Water D00 ,--- C�{ i` a �U Ys 4_.b <br /> C �c s S csv " O C N Co� <br /> w O WELLHEAD PROTECTION AREA p Lo ` z . <br /> i o DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> f-n. HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area ( s) ; list <br /> pertinent information and questions . <br /> moles c EFL <br /> yes Ex o <br /> ►-►CC FP COP <br />