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DANE COUNTY Zoning Division <br /> . PLANNING DEVELOPMENT Room 116, City-County Building <br /> � 4, ° 210 Martin Luther King Jr. Blvd. <br /> A.,a <br /> �� � Madison, Wisconsin 53703-3342 <br /> f:- `;- Zoning Change Application Phone: (608) 266-4266 <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 Ai i ! , Agent's Name <br /> Address 6511 I 'tpki eot Ore? 01 53575 Address <br /> Phone 100g-67)W- 7,35 Phone <br /> ex);fylitkvwv wlAf l . Covvti <br /> Email Email <br /> Town OreDY1 Parcel numbers affected: D 4 2,/0061 - !tog- 6,25 -3 <br /> Section: 01 Property address or location: 557/ (?2496'1 Ad. <br /> Zoning District change: (To/From/#of acres) 1L-) l"O e_.-3 O..a2rc S <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other:_ % <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> O Separation of buildings from farmland <br /> O Creation of a residential lot <br /> O Compliance for existing structures and/or land uses <br /> Ci Other: <br /> 2 01110 D ►1pl tetetC6 ' o flo w redut ed c+L5_ <br /> PrvpOsir5 i p;f- or) an add ifio,- `10 house. <br /> 1 authorize that I am th wner or have , ission to act on behalf of the owner of the property. (0737/6 <br /> Submitted By: ��. 4, Date: <br />