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� Cc <br /> REZONE PETITION # C,, Z4 CONDITIONAL USE PERMIT # x <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 /> i-.t o FLOOD PLAIN <br /> 140 WETLANDS <br /> yes SHORELAND - Body of Water <br /> WELLHEAD PROTECTION AREA 3 0 i/0 �L L.o L_. <br /> p0 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 /> yes <br /> v 'n e 5 <br /> GP Go N7 YES <br /> PET_ Co fCP(o - ,d o r2 co.- d <br /> 66 nEp <br />