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REZONE PETITION # &36d 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 /> `le-5 FLOOD PLAIN <br /> yes WETLANDS <br /> 0, It c oc,e. 4-ecL <br /> YG=S SHORELAND - Body of Water 1(_05 ILO vt o`c e <br /> 7055. WELLHEAD PROTECTION AREA <br /> No DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> ov HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> \ e 5 d P - 2 1-A- I � c--e j ` a R - (` I) - I p�.-c-c ( o t y <br /> "les �o C— XEc__ MGa lb <br /> �g5 FP CoPy <br />