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DANE COUNTY : Zoning Division <br /> PLANNIN '`--- -: E l_P E T Room 116, City-County Building <br /> a <br /> o_�, 3-" '' - 210 Martin Luther King Jr. Blvd. <br /> _ , <br /> Madison, Wisconsin 53703-3342 <br /> IVli <br /> k ®nAng Change Application <br /> Phone: (608) 266-4266 <br /> sa g <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 o\-\ ecs.c.---.11 Agent's Name <br /> Address 21 S 1\10 c L N DC\ Address <br /> Phone GV1, -7 7 6 6 5 5 /p •Phone <br /> C:Al cni 321- - <br /> Email .- oc lv M N-1- C, .0.G Email <br /> Town' 3w c o\JN I S Parcel numbers affected: 0 I 0 /0 6 d` -'S1 t -. 8 5 C b - 7 <br /> • <br /> Section: 01 Property address or location: <br /> Zoning District change: (To/From/#of acres) <br /> • <br /> Soil classifications of area(percentages) - Class I soils: % Class I I soils: % Other._ % <br /> • <br /> —Narrative:-(reason-for-change,-intended-land-use,-size-of-farm,-time-schedule) <br /> ® Separation of buildings from farmland <br /> 8 Creation of a residential lot - <br /> 0 Compliance for existing structures and/or land uses <br /> 0 Other <br /> • <br /> • <br /> • <br /> I authorize that I am the owner or have permission to act on behalf of the owner of the property. <br /> Submitted By: Date: <br /> - I <br />