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DANE COUNTY Zoning Division <br /> �t�d'.r,, PLANNING DEVELOPMENT Room 116, City-County Building <br /> ,i' r 1r'1,= 210 Martin Luther King Jr. Blvd. <br /> 11 l Madison, Wisconsin 53703-3342 <br /> ,t,11V Zoning Change Application Phone: (608) 266-4266 <br /> �7-: lv 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/h / h6 Agent's Name <br /> Address (r)661,2 U)(au ),( I� Address 06 <br /> � 4 - 519 - zi9 u fl y`( <br /> Phone Phone sa <br /> 5-77- 6STrD G <br /> Email , <br /> roil Sri/�i-lea mil-crn ,r irn i I. (PM <br /> Town. Ni Aft Parcel numbers affected: 0 C L."?' f I ._ Esc?? 0 <br /> Section: 01 Property address or location: L,69,,2, U)Aricce 1L . dv/( )( `°ij5 9 <br /> Zoning District change: (To/From/#of acres) <br /> I -- a ( , ; (A c f S <br /> Soil classifications of area (percentages) Class I soil : % CI s II soils: % Other: % <br /> ,., €_ ■_. -;) 44 C il <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> O Separation of buildings from farmland <br /> ® Creation of a residential lot <br /> O Compliance for existing structures and/or land uses <br /> O Other: <br /> A-44..")' q A -fa//er -s/ e(9C' <br /> I authorize that I am th er or have permission to on behalf of the owner of the property. <br /> Submitted By: �� /, �2 � Date: / � / w <br />