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DANE COUNTY Zoning Division <br /> PLANNING DEVELOPMENT Room 116, City-County Building <br /> Ny' ] \e- 210 Martin Luther King Jr. Blvd. <br /> Madison, Wisconsin 53703-3342 <br /> '.�,Ff Zoning Change A pp lication 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 /> 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 pc U 1 05.7.m e,,,,F s L L c Agent's Name �Qe, rr � <br /> WA HGJti/ <br /> Address a$ ! Hb,Je7 Lo1''C Siva,i ,Address 4157/ Ayer f.A* <br /> Phone a'-9732Soa Phone t -�73 J'S-o0 <br /> Email z Email } <br /> tt�� 0011 L..I(Z S?c 04i#TdN7-44,/Gel2S,c o•, . piat)e$17. zsi iQ,AAEft,Cbm <br /> Town: ICtia.A ft Parcel numbers affected: 1 0 S i d 3 r Z (SQ f 0 <br /> Section: 01 Property address or location: 36 OLD d ian r� <br /> Zoning District change: (To/From/#of acres) RN-i From f.e off, $' ActE$ <br /> rw, — II ctc_ /�-1�2 z< <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other:_ % <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> 0 Separation of buildings from farmland <br /> e Creation of a residential lot <br /> O Compliance for existing structures and/or land uses <br /> O Other: nn <br /> Apmr/oaf.e� Ece-/T Ft)? PoPeos t <br /> / <br /> I authorize that I am th r or ha rmissron 5 a o behalf of the owner of the property. <br /> Submitted By: Date: is- I c- Zrl i <br />