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REZONE PETITION # (,38; 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 /> _o FLOOD PLAIN <br /> o WETLANDS <br /> �,a o SHORELAND - Body of Water <br /> ',Do WELLHEAD PROTECTION AREA <br /> o DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> I,Do HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> yes D. r_. . <br /> `l{S - Co . E- ec• t---( 40,440 <br /> "(iS FP Coe-, <br />