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Dane County Rezone & Application Date Petition Number <br /> 10/20/2016 DCPCUP-2016-02367 <br /> Conditional Use Permit Public Hearing Date C.U.P.Number <br /> 12/13/2016 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> RAMSEY PIT LLC Code) Code) <br /> (608) 884-9106 (608) 884-9106 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 1400 RAMSEY RD 1400 RAMSEY RD <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 STOUGHTON, WI 53589 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> ADDRESS/LOCATION 1 ADDRESS/LOCATION 2 ADDRESS/LOCATION 3 <br /> ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION 0 NE/CUP ADDRESS OR LOCATION OF REZONE/CUP <br /> 1412 Ramsey Rd. <br /> TOWNSHIP TOWNSHIP SECTION 1 • SECTION <br /> ALBION 'SECTION 0.6 <br /> PARCEL NuMBERS:NNOLVED PARCEL N ':E PARCEL NUMBERS INVOLVED <br /> 0512-061-9001-3 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> FROM DISTRICT: TO DISTRICT;.;, ACRES DANE COUNTY CODE OF ORDINANCE SECTION I ACRES <br /> C.S.M REQI 0QL( A ED RESTRICTION INSPECTOR'S INITIALS SIGNATURE:(Owner or Agent) <br /> r" " REQUIRED? <br /> 11 Yes [ M Ir CC:We Yes ❑ No <br /> .1�£SG, <br /> DJE1 ■ i4/? '"6---d---...----6-- <br /> LEGAL <br /> Applicant Initials icant Initials T NAME: <br /> --- II) A/ti. --c/a//j <br /> DATE: <br /> / 2 /( <br /> Form Version 03.00.03 <br />