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REZONE PETITION # c34b 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 /> n)o FLOOD PLAIN <br /> 100 WETLANDS <br /> X PO SHORELAND - Body of Water <br /> 17055 WELLHEAD PROTECTION AREA <br /> too DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> v po HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> /ES D E D <br /> ✓-1 E-S c o E c. r-1 F r-4 o <br /> po copy <br />