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REZONE PETITION # (, 3 ( 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 /> No WETLANDS <br /> ye.s SHORELAND - Body of Water 1 +e r 4a S+f-eau.` <br /> -}✓i `y -Fv 1-4ud C e k <br /> WELLHEAD PROTECTION AREA ,, ; +c , 300 ' <br /> 1_40 DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> No HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> iii 0 .b ED <br /> / Go FiXec' Me �4co <br /> r►o FP Co r/ <br />