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* 5 <br /> REZONE PETITION # (. 3/-5 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 /> oo FLOOD PLAIN <br /> ,moo WETLANDS <br /> No SHORELAND - Body of Water <br /> po WELLHEAD PROTECTION AREA <br /> too DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s) ; list <br /> pertinent information and questions . <br /> D . E .f? <br /> Fi? Cols/ <br />