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Dane County Rezone & Application Date Petition Number <br /> 08/17/2016 DCPREZ-2016-11050 <br /> Conditional Use Permit Public Hearing Date C.U.P.Number <br /> 10/25/2016 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> SUTTER LIVING TR Code) DCBF TRANSITION TRUST Code) <br /> (608) 575-1884 (608) 437-6163 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 2230 STATE HIGHWAY 78 10123 FERTILE RIDGE RD., <br /> (City,State,Zip) (City,State,Zip) <br /> MT HOREB, WI 53572 Mt. Horeb, WI 53572 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> dcrbrunk @mhtc.net <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 /> east of 10123 Fertile Ridge Rd. 10123 Fertile Ridge Rd <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> BLUE MOUNDS 22 BLUE MOUNDS 22 <br /> PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL.NUMBERS INVOLVED <br /> 0606-224-8720-9 0606-224-8690-6 <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 RH-2 Rural Homes .5 <br /> District District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S INITIALS SIGNATURE:(Owner or Agent) <br /> REQUIRED? <br /> 10 Yes ❑ No ❑ Yes 0 No ❑ Yes ® No <br /> SCW1 I • /\ .AA.A.ij <br /> Applicant Initials Applicant Initials Applicant Initials PRINT NAME: <br /> �F <br /> ekixv`(IS Q.. ( . vi Pt- <br /> DATE: <br /> Form Version 03.00.03 <br />