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DANE COUNTY Zoning Division <br /> ti,1=x`i> PLANNING DEVELOPMENT Room 116, City-County Building <br /> 7, .lr` . 210 Martin Luther King Jr. Blvd. <br /> r< . Madison,Wisconsin 53703-3342 <br /> ,,¢<<::' V 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 1n {.f.it� Agent's Name I6 I^.e,,�'\ , 1-0 I 0. <br /> Address C b<(,'/u gi,�,e}'hi A Rd Address / ) 0 e?'^DQ h i 451/O-' <br /> Phone pre 4✓.v 7 3 Ca,c Phone Sir\ P f ` ;Pit-E. ' .J1 S 35 C <br /> (Got) 5-76 -O$1 ), <br /> Email Email D <br /> jAhcka9c& rnrA;I,c4M �p30/r'�a Z( 1,-.� . ) , C - <br /> Town. C.o 'eye G(1V& Parcel numbers affected: 0/11-3611001-0/J 0 711- 3d-$col d-C <br /> Section: 01 Property address or location: <br /> Zoning District change: (To/From/#of acres A— ,__ A <br /> Soil classifications of area(percentages) Class I soils: % Class II soils: % Other:1C % <br /> N rra ive: reason for change, intended land use, size of farm,time schedule) <br /> Separation of buildings frO farm d' <br /> Creation of a residential lot <br /> 0 Compliance for existing structures and/or land uses <br /> "e-gelar: <br /> I authorize that I am the own). , issio.to act.• . •.If of the owner of the property. ‘� <br /> Submitted By: 4;l , , /: Date: <br /> or <br />