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<br /> DANE CouNTY Zoning Division ll1
<br /> 5
<br /> PLANNING ,-
<br /> Q -tea EVELOPd E Room 116, City-County Buildin g
<br /> 210 Martin Luther King Jr. Blvd.
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<br /> Madison, Wisconsin 53703-3342
<br /> (w Zoning Change Application Phone: (608) 266-4266
<br /> scQ Fax: (608) 267-1540
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<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 k- a o N h b A . 2-u).y Agent's Name
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<br /> Address F i M / A. / 7'A K s r Address / /f' S- V1/,,,d.�, o f c,�. l,
<br /> Phone Phone NI 4.- d,s 0A 1/4,,v 2 S 3 -7 / 1
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<br /> Email Email
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<br /> Town. M A Z o A N l e Parcel numbers affected: 034-/ 0 ,10/d — 3 6 3 ,, 8 r o o _ /
<br /> Section: 01 Property address or location: G "k`k` /2 an d /t'1 A. 2 o n L,t/
<br /> Zoning District change: (To/From/#of acres) 'ro A - 11- F r P/1, A - 1 6:AC 3, / k-4 r`f
<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 /> e Other:�,/ / / / .✓
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<br /> I authorize that I am the owner or have permission to act on behalf of the owner of the property. 9 — 30 - .s—
<br /> Submitted By: 1214- S 1— ` Date:
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