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PLANNIN <br /> DANE COUNTY Zoning Division <br /> 0---i----":2`')' -- E` ELOpT E T Room 116, City-County Building <br /> o'; ,. 210 Martin Luther King Jr. Blvd. 1 <br /> 1�', _ Madison, Wisconsin 53703-3342 <br /> s ,_. Zoning Change Application Phone: (608) 266-4266 <br /> Fax: (608) 267-1540 <br /> Items that must be submitted with your application: <br /> t <br /> o Written Legal Description of the proposed Zoning Boundaries <br /> 4 <br /> Legal description of the land that is proposed to be changed. The description may be a lot in a plat, <br /> 1 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 /> i feet <br /> o Scaled Drawing of the location of the proposed Zoning Boundaries <br /> j 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 /> II II Owner's Name /I ,.t r ,� ; Q Agent's Nam <br /> 11 Address Jexyt ,,CCv /kc,kf/ 35 � Address 0 c�Y / al Ai Svc NA '4L <br /> Phone Co ti- h H' / 1- .4i cv Y Phone g37- 6 O c <br /> Poy he 1417- 532 ,5 <br /> Email Email 0---F n ALI" s,--9 erpoit)tie-A, ,ow <br /> _ q 1 <br /> Town.CO I v 'p4 .(/�MP rcel numbers affected: d Q 1 I i — /000 -`f C2 g (l—oVY—/rh a T <br /> Section: � G U Property address or location: S 19 a C-#Y A/ S o Iti ,'�"(� / (. <br /> Zoning District change: (To/From/#of acres) A' p� C c1 ) r- ( 0 /1 c CL U $1 UE- P"i.. <br /> 1 A . .3 ,tfc 4 Es A -- I <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other._ % ;! <br /> N rative: (reason for change, intended land use, size of farm, time schedule) <br /> Separation of buildings from farmland <br /> 0 Creation of a residential lot • <br /> 0 Compliance for existing structures and/or land uses <br /> 8 Other: j C. 1 c 6I, ) 4, K c,, 4-. 6143 (it re- /- c a( <br /> I authorize that lam the ow -r or have aermissi to act on b;1.1, 7 of the owner of the property. L/ /(71- / <br /> Submitted By: ���_ " ��/� Date: t T C <br />