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LANE COUNTY _:_ Zoning Division <br /> .s;: EL PM ENT Room 116, City-County Building <br /> 0,- � 210 Martin Luther King Jr. Blvd. <br /> �'"` _ �. Madison, Wisconsin 53703-3342 <br /> ,51 •�, Zoning Change Application Phone: (608) 266-4266 <br /> yAf� 1919 C <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 Any + E-a Ii �EU)o I Agent's Name <br /> Address I-`i tRi-{ : t—t C 1 Ril Address <br /> r <br /> �Lr CK' I Pk R-1-14 t3/ 5 -3 5 /5- - <br /> Phone &�� _ -=it) -C-113'-x- Phone <br /> Email Email <br /> NNr—ts-N) tv ciy�+ �1., cct l <br /> Town. 6 =K r-�y Parcel numbers affected: L nC; f" _3P - 1 5-0-- 4 C CC� .3 L <br /> Section: 01 Property address or location: , <br /> Zoning District change: (To/From/#of acres) H - :-£ X t ii-:4-CL) <br /> ■ <br /> Soil classifications of area (percentages) Class I soils: % Class I I soils: % Other._ % <br /> Narrative:-(reason-for-change,-intended-land-use,-size-of-farm,-time-schedule)-- - — <br /> ® Separation of buildings from farmland <br /> • Creation of a residential lot . <br /> O Compliance for existing structures and/or land uses <br /> 8 Other: <br /> r,t,v, a , 3J r" ef... . 1 1,:!_.,._n,, - ✓ N t___! r To I3 U 1 L) A ti I M E . <br /> XI >T / NC�- tic, leie- 4NI> _t-1 WILL _BE R /Li0VEh <br /> I authorize that I am te`owner or have permission to act on behalf of the owner of the property. V j / X5 <br /> Submitted By: ! l „,_,6,1-7,-,4_.--- Date: / <br />