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DANE COUNTY Zoning Division <br /> PLANNIAIpEV'EL,QPMENT Room 116,City-County Building <br /> 210 Martin Luther King Jr. Blvd. <br /> w Madison,Wisconsin 53703-3342 <br /> t-,--A='.Y Zoning Change Application Phone: (608)266-4266 <br /> Fax: (608) 267-1540 <br /> Items that must be submitted with your application: <br /> o Written Legal Description of the proposed Zoning Boundaries <br /> Legal description of the land that is proposed to be changed. The description may be a lot in a plat, <br /> Certified Survey Map,or an exact metes and bounds description. A separate legal description is <br /> required for each zoning district proposed. The description shall include the area in acres or square <br /> feet. <br /> o Scaled Drawing of the location of the proposed Zoning Boundaries <br /> The drawing shall include the existing and proposed zoning boundaries of the property.All existing <br /> buildings shall be shown on the drawing. The drawing shall include the area in acres or square feet. <br /> Owner's Name GREGORY H HEISIG .D aft Vir1G1 Agent's Name BIRRENKOTT SURVEYING INC. <br /> Address 2074 US HIGHWAY 12 & 18 Address 1677 N. BRISTOL ST. SUN PRAIRIE, <br /> COTTAGE GROVE WI 53527 WIS. 53590 <br /> Phone Phone <br /> (608)658-0105 (608)837-7463 <br /> Email Email akasper @birrenkottsurveying.com <br /> Town Cottage Grove <br /> Parcel numbers affected: 018/0711-352-9301-6 .f 019)0111- 352 -goof- q <br /> 144 CA•11 <br /> Section: 35 Property address or location:2074 US HIGHWAY 12&18 <br /> Zoning District change: (To/From/#of acres)A-1 ex/ RH-1 /0.50 <br /> RN-I /A-I ex 1 O. 3L <br /> Soil classifications of area(percentages) Class I soils: % Class II soils: .21._% Other. 50 <br /> Narrative: (reason for change, intended land use, size of farm,time schedule) <br /> O Separation of buildings from farmland <br /> O Creation of a residential lot <br /> O Compliance for existing structures and/or land uses <br /> O Other. <br /> Swapping empty lands with the adjoining land owner for lands with and existing out <br /> building. <br /> I authorize that I am the o - or ha permission .act on behalf of the owner of the property. <br /> Submitted By: Date: <br /> As As <br />