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I DANE COUNTY Zoning Division <br /> PLANNING DEVELOPMENT Room 116, City-County Building <br /> '. ,, <br /> 210 Martin Luther King Jr. Blvd. <br /> _ Madison Wisconsin 53703-3342 <br /> a_ -t-41 Zoning Change Application <br /> 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 /> 1 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 /> Name /� .:F- <br /> Owner's !, , OL i . L • Agent's Name �,' / <br /> Address O e''', :�'�tllll//�%%�� - Address i// , �T 'Cl ' <br /> �� ' <br /> Phone Phone <br /> Crog- 7/�o4, <br /> � Email ■ „�/ Email � - lJ <br /> /4'1"1 es! GY / A . 1 <br /> Town* 1/1/(0/1.1-405 e Parcel numbers affected: GscS'o39.9-‘49' -( <br /> 1 <br /> Section:1r 021 Property address or location: c1O ell- 4 <br /> Zoning District change: (To/From/#of acres) t—iE * — ( <br /> II <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other:_ % <br /> 1I <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> 0 Separation of buildings from farmland <br /> Creation of a residential lot <br /> 0 Compliance for existing structures and/or land uses <br /> 0 Other: <br /> d"-t... i it 7,1„ . ' ,il Lo, • e 1-7L,Z, A,. ie. J i ' <br /> I <br /> 1 <br /> I authorize that I am the owner or have permission to act on behalf of the owner of the property. <br /> Submitted By: Date: <br />