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Dane County Rezone & Application Date Petition Number <br /> 01/29/2016 DCPREZ-2016-10960 <br /> Conditional Use Permit Public Hearing Date C.U.P.Number <br /> 5/Lo/I Io -84/26/20t6- <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> PATRICIA L ANNEN Code) Code) <br /> (608) 592-4233 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 6392 VIADUCT RD <br /> (City,State,Zip) (City,State,Zip) <br /> DANE, WI 53529 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> COUNTRYLI FE @MYFRONTIERMAI L.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 /> 6392 VIADUCT ROAD <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> DANE 12 <br /> 0908-121-8280-0 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> REZONING TO A DISTRICT WHICH ALLOWS FOR A <br /> TALLER SHED. <br /> OR <br /> R-3 Residence District A-2 (1)Agriculture 1.06 <br /> District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S INITIALS SIGNATURE:(Owner or Agent) <br /> REQUIRED? <br /> Yes ❑ No ❑ Yes ® No ❑ Yes ❑ No 7 • <br /> PMK2 r/a Q- 7 <br /> Applicant Initials Applicant Initials Applicant Initials PRINT NAME: <br /> COMMENTS: REZONING TO A DISTRICT WHICH ALLOWS FOR A TALLER <br /> SHED. 24,7 L . TrV1 n-e s� <br /> r>c�a. <br /> DATE: <br /> Form Version 03.00.03 <br />