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REZONE PETITION # b3Z., 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 /> 00 FLOOD PLAIN <br /> 1-10 WETLANDS <br /> ti►o SHORELAND - Body of Water <br /> Ho WELLHEAD PROTECTION AREA <br /> Sao 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 /> No i tD <br /> 5 Co txe <br /> i�liZ rp Co 1 <br />