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• <br /> DALE COUNTY <br /> Zoning Division <br /> ` '' DEVELOPMENT Room 116, City-County Building <br /> o „�F�- 210 Martin Luther King Jr. Blvd. <br /> Si « � - Madison, Wisconsin 53703-3342 <br /> ck 61919: honing Change Application ( ) 66-4266 <br /> ea s,. <br /> Phone: 608 2 <br /> Fax: (608) 267-1540 <br /> . <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 LULL/44,1,z, Ho ,51r a Agent's Name/Viet/LA J 4, <br /> Address 6. 67- !f rcrtv(�((2I- D/'Ilj-c- Address 7-4' 55 atx-S7-avu- -0ad <br /> f - "3q1/S0-,, liC..T 5 17/� Phone �if��GroV2/�"� 535z. ,j <br /> Phone (6 a / <br /> s) 2.27_ - 5 2 0 C 6002:2)5--72s 'Z <br /> Email Email // <br /> .vo rt-e_ lift-tec/919 1,1444.C, GcrIA-,.. <br /> ii <br /> TownaOffek-dr-4rr'ove- Parcel numbers affected: 071/ -O"/- 8O/1 .- 5/07/J-a4/-g//6-5 <br /> Section: 01 04 Property address or location: 7.145 64. ,,)2o dat.Cii C" f,--0,0,ice.. <br /> Zoning District change: (To/From/#of acres) R I /I{-f t(O.7 5 <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other. <br /> 1 <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> 0 Separation of buildings from farmland <br /> Compliance for existing structures and/or land uses <br /> A Other: <br /> Add,f...., tad*,;,,,,.....e 67,,, -,4,, 04ti )1.1.3 palt-Lati <br /> j <br /> I authorize that I am the • Ifer . have pe r• sic, '. act on behalf of th- owner of the property. �� f <br /> Submitted By: Z.47 ad ' - Date: ��!/ <br />