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z.' <br /> REZONE PETITION # (e36•(/ CONDITIONAL USE PERMIT # IZ7o <br /> C.U.P. ONLY: Act i ' s 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 /> po FLOOD PLAIN <br /> WETLANDS <br /> po SHORELAND - Body of Water <br /> po WELLHEAD PROTECTION AREA <br /> ,J(2 DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> oo HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> yes p. �. P <br /> `/es �x . 1--kEMO <br /> files F. P . COPS <br />