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Dane County Rezone & Application Date Petition Number <br /> 07/13/2015 DCPREZ-2015-10884 <br /> Conditional Use Permit Public Hearing Date C.U.P. Number <br /> 08/25/2015 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> ROGER J OLSON Code) JOCELYN SARBACKER Code) <br /> (608) 884-4930 -16' (608) 712-4829 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 645 ALBION RD 636 ALBION ROAD <br /> (City,State,Zip) (City,State,Zip) <br /> EDGERTON, WI 53534 Edgerton, WI 53534 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> Iaura.olson @edgerton.kl2.wi.us bensarbacker @gmail.com <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 /> $ /r4/ 01 / <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> ALBION 21 <br /> PARCEL NUERIEERS INVOLVED PARCEL NUMEIERO INVOLVED PARCEL NUNIEIRS INVOLVED <br /> 0512-211-9700-5 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> CREATING ONE RESIDENTIAL LOT <br /> PROM DISTRICT: TO DISTRICT; ACRES DANE COUNTY CODE OF ORDINANCE SECTION I ACRES <br /> A-1 Ex Exclusive Ag RH-1 Rural Homes <br /> District District f <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S INITIALS SIGNATURE:(Owner or Agent) <br /> REQUIRED? <br /> Yes ❑ No El Yes ® No El Yes ® No <br /> • • ,�/� AMA1 CR � on: <br /> Applicant Initials *O Applicant Initials Applicant Initials= ]��" PRI NAME: <br /> u U <br /> hoc EL�f N <br /> DATE: <br /> c <br /> 7- 3 -- <br /> CSM/DOC# 19Q30/saa°1I3y <br /> � � <br /> DEED RESTRICTION: Form Version 03.00.03 <br /> DEED NOTICE: <br /> OTHER: <br />