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DANE COUNTY Zoning Division <br /> �, PLANNING DEVELOPMENT Room 116, City-County Building <br /> ice,' 1 = A 210 Martin Luther King Jr. Blvd. <br /> ��.�' .-0 Zoning n Change Application <br /> Madiso`, Wij consin 53703-3342 <br /> 1,. g g Phone: (608) 266-4266 <br /> v 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 (f z,i_ /wa___4,3,e_ Agent's Name <br /> Address g/c Aaa5 /a -L-7&- / / Address <br /> ��ivt�ai /lf� K/ <br /> Phone / f Phone <br /> 6 ;?i9 .7. ,5? 7 <br /> Email Email <br /> /Y7a/`le� �� QC71ra <br /> Town: i "■4 I a ' of Parcel numbers affected: 69 S 1' d _ Z Yr/ 550-,0 <br /> e c/o -- /39 - 9i7i - 0 / 3y - 9soz -0 <br /> Section: 01 0 1 f Property address or location: <br /> �- $ / - 15 4 5,e /.4 k.. i ) <br /> Zoning District chap : (To/From/# acres) " / EX C—/tic S I%/C._ A i v i`c L ( 4-IA ✓ e <br /> �o / ff - 3 l,, r- � f owes <br /> Soil classification 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 /> pc,iSeparation of buildings from farmland <br /> o Creation of a residential lot <br /> o Compliance for existing structures and/or land uses <br /> O Other: <br /> I authorize that I a e o er or ha = :'.' to . .n .= alf of the owner of the property. --.2 — /' <br /> Submitted By: i / Da <br />