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g <br /> REZONE PETITION # (14 CONDITIONAL USE PERMIT # <br /> C.U.P. ONLY: Action is/is not requesedd Hearing . <br /> t <br /> Date <br /> Place an "X" in the box if all or part of the any of <br /> proposed Rezone/C .U . P . area is affected by Y <br /> the districts below: <br /> 00 FLOOD PLAIN <br /> gars■ bl WETLANDS c- e5 bo� � d .7, A -Z <br /> 00 SHORELAND - Body of Water <br /> 1.30 WELLHEAD PROTECTION AREA <br /> b_Dd DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> 06 HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: Describe location of affected area ( s ) ; list <br /> pertinent information and questions . <br /> y-e5 Lo• � 1CeC . f'�2 LA-4.6 <br /> v-vcz- PP Lori <br />