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Dane County Rezone & Application Date Petition Number <br /> 01/21/2016 DCPREZ-2016-10955 <br /> Conditional Use Permit Public Nearing Date C.U.P.Number <br /> 03/22/2016 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> DALE E BONESS Code) WILLIAMSON WILLIAMSON SURVEYING AND <br /> (608) Code) <br /> ASSOCIATES, LLC (608)255-5705 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 2292 COUNTY HIGHWAY Z 104A W. MAIN STREET <br /> (City,State,Zip) (City,State,Zip) <br /> BLUE MOUNDS, WI 53517 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> CHRIS.ROSBOROUGH @MCGLADREY.COM CHRIS @WILIAMSONSURVEYING.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 /> 2292 COUNTY HIGHWAY Z 2292 COUNTY HIGHWAY Z <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> BLUE MOUNDS 19 BLUE MOUNDS 19 <br /> 0606-194-8000-7 0606-191-9750-1 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> SEPARATING EXISTING RESIDENCE FROM <br /> FARMLAND <br /> Zrr �6W �'' ��� '�+'4� F ���`��+ 4"' 2. ,aid <br /> A-1 Ex Exclusive Ag A-2(8)Agriculture 12.44 <br /> District District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTORS INITIALS SIGNATURE:(• er • •gent) <br /> REQUIRED? <br /> ® Yes ❑ No ❑ Yes ® ,�N9q� ® Yes o <br /> 1 t�1J PMK2 <br /> Applicant Initials Applicant Initials Pr Applicant Initials PRINT •ME: <br /> COMMENTS: SEPARATE THE EXISTING HOME AND BUILDINGS FROM THE <br /> REMAINING FARMLAND. ,o, gi, <br /> DATE: <br /> CSM/DOC#: 11- P31/ca33735 <br /> DEED RESTRICTION: Form Version 03.00.03 <br /> DEED NOTICE: <br /> OTHER: <br />