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REZONE PETITION # (,33o 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 /> No FLOOD PLAIN <br /> WETLANDS <br /> 0041,57 SHORELAND - Body of Water <br /> 4-I- b y 1 O L o Ci i t-4 c.r S l` I e r <br /> �,— �+ts"" WELLHEAD PROTECTION AREA 4-0 c ;s ; S ,, ; 4- ,; ,t <br /> �otp <br /> oS- 5 co oc c -lam S �c rc� 1 <br /> 1-40 DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> I.)0 HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> DE <br /> y�S c ,e <br /> Yom- Fp cop/ <br />