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REZONE PETITION # (p4} II 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 /> 100 FLOOD PLAIN <br /> 00 WETLANDS <br /> iT <br /> SHORELAND - Body of Water <br /> ,.fib WELLHEAD PROTECTION AREA <br /> oo DANE COUNTY REGIONAL AIRPORT HEIGHT <br /> LIMITATION AREA <br /> po HISTORIC OVERLAY DISTRICT (Indian Burial <br /> Mounds) <br /> COMMENT: De=scribe location of affected area (s ) ; list <br /> pertinent information and questions . <br /> Yes p . E . D . <br /> yes Co. cxEc . ►-tEw-(O <br /> Co y <br />