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Dane County Rezone & Application Date Petition Number <br /> 05/19/2016 DCPREZ-2016-11011 <br /> Conditional Use Permit Public Hearing Date C.U.P.Number <br /> 07/26/2016 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> BERDINE M ALME Code) WISCONSIN MAPPING LLC Code) <br /> (608) 628-1162 (608) 764-5602 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 919 TOWER RD 306 W QUARRY ST <br /> (City,State,Zip) (City,State,Zip) <br /> STOUGHTON, WI 53589 DEERFIELD, WI 53531 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> WISMAPPING @CHARTER.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 /> 919 TOWER DR <br /> TOWNSHIP TOWNSHIP SECTION TOWNSHIP SECTION <br /> DUNKIRK 'SECTION <br /> 14 <br /> PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED <br /> 0511-144-8001-0 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> SEPARATING EXISTING RESIDENCE FROM <br /> FARMLAND <br /> FROM DISTRICT; TO DISTRICT; ACRES DANE COUNTY CODE OF ORDINANCE SECTION f ACRES <br /> A-1 Ex Exclusive Ag A-2 (2)Agriculture <br /> District District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S INITIALS SIGNATURE:(Owner or Agent) <br /> REQUIRED? <br /> ® Yes ❑ No ❑ Yes ® No ❑ Yes ® No <br /> i a HJH3 )(A4(0,/,22 <br /> Appli Applica Applican SR <br /> PRINT NAME: <br /> gash R�esvp <br /> ,9 /i6 <br /> CSM/DOC: (I f l-i 13/5.79t4 y 1 9 Form Version 03.00.03 <br /> DEED RESTRICTION: <br /> DEED NOTICE: <br /> OTHER: <br />