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Dane County Rezone & Application Date Petition Number <br /> a. Conditional Use Permit 08/19/2015 DCPREZ-2015-10902 <br /> Public Hearing Date C.U.P.Number <br /> 10/27/2015 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> JANET L BERGE Code) WISCONSIN MAPPING LLC Code) <br /> (608)764-5778 (608) 764-5602 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 961 NULAND RD 306 WEST QUARRY <br /> (City,State,Zip) (City,State,Zip) <br /> DEERFIELD, WI 53531 Deerfield,WI 53531 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ADDRESS/LOCATION 1 ADDRESS/LOCATION 2 ADDRESS/LOCATION 3 <br /> ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP <br /> 935 Nuland Road <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> DEERFIELD 33 <br /> x *01 s _ r1 F*70 N * i I fii D r <br /> 0712-333-8000-3 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> CREATING ONE RESIDENTIAL LOT <br /> .7i4AM:;10)000 eat' <br /> A-1 Ex Exclusive Ag R-1 Residence District 1.2 <br /> District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S SIGNATURE:(Owner or Agent) <br /> REQUIRED? INITIALS <br /> Yes ❑ No ❑ Yes ® No ❑ Yes ® No RLB 4, 4- <br /> Applicant Initial "` Applicant Initials 1 Applicant Initialy p NAME: <br /> NI/ poet) esc <br /> DATE: <br /> csM/Doc# ly�o�/saa‘15 - 8 )7 )s--- <br /> DEED RESTRICTION: Form Version 03.00.03 <br /> DEED NOTICE: <br /> OTHER: <br />