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Dane County Rezone & Application Date Petition Number <br /> 02/26/2016 DCPREZ-2016-10970 <br /> Conditional Use Permit Public Hearing Date C.U.P.Number <br /> 5/I • 16 2016- <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> CHARLTON REV TR, SERENA Code) WILLIAMSON SURVEYING Code) <br /> (608) 845-3460 (608)255-5705 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 3391 COUNTY HIGHWAY J 104A W MAIN ST <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> serenacharlton @tds.net chris @williamsonsurveying.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 /> 3391 COUNTY HIGHWAY J <br /> TOWNSHIP TOWNSHIP SECTION TOWNSHIP SECTION <br /> CROSS PLAINS !SECTION <br /> 35 <br /> PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED <br /> 0707-351-9510-0 0707-362-9200-0 0707-362-9690-0 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> SHIFTING OF PROPERTY LINES BETWEEN <br /> ADJACENT LAND OWNERS <br /> FROM DISTRICT: TO DISTRICT: ACRES DANE COUNTY CODE OF ORDINANCE SECTION . I ACRES <br /> A-1 Ex Exclusive Ag A-2 Agriculture District 21.13 <br /> District <br /> R-1 Residence District A-2 Agriculture District 0.90 <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 <br /> SSA1 <br /> Applicant Initials Applicant Initials Applicant Initials PRINT NAME: <br /> DATE: <br /> CSM/DOC#: 4 a 5 as 965c, <br /> DEED RESTRICTION: <br /> DEED NOTICE: Form Version 03.00.03 <br /> OTHER: <br />