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DANE COUNTY Zoning Division <br /> PLANNING <br /> D E V E LO P M E N T Room 116,City-County Building <br /> " 210 Martin Luther King Jr. Blvd. <br /> Madison,Wisconsin 53703-3342 <br /> x 41 Zoning Change Application Phone: (608)266-4266 <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 Furseth Brothers Real Estate Agent's Name Wisconsin Mapping LLC <br /> Address 2157 County Highway A Address 306 W. Quarry St. <br /> Stoughton, WI. 53589 Deerfield, WI. 53531 <br /> Phone Phone <br /> (608)873-5856 (608)764-5602 <br /> Email danielfurseth@yahoo.com Email wismapping©charter.net <br /> @Y pp g @charter.net <br /> Town: Rutland Parcel numbers affected: 0510-142-8520-3 <br /> Section: 14 Property address or location: 1033 Lake Kegonsa Rd. <br /> Zoning District change: (To/From/#of acres)A-1 (EX) to A-2(1) 1.7 acres <br /> Soil classifications of area(percentages) Class I soils: % Class II soils: 100 % 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 /> O Other: <br /> I authorize that I am •- own.r or ve permis n to act on behalf of the owner of the property. ` /���� <br /> Submitted By: Date: <br />