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• Specific Location/Rural Address Request <br /> (Entire Form To Bee}Com letely Filled Out Before Staff Can Respond to the Request) <br /> Today's Date g/f / or <br /> Township / Section of Needed Address S r i )e. © 6 <br /> Specific Area/Nearby Roads Ge_ © � �^ <br /> Parcel # 02^ D G 2 ^ e2',- D DANE COUNTY <br /> Person/Entity making this request- \ • \ COQ Abe ` AUG 1 9 2008 <br /> Contact Information for requestor 1 ZONING DIVISION <br /> rn o�o-u r� u, 53 s 7 ' <br /> was-- 19 <br /> Date of Original Request to this Agency (Date Stamp here) <br /> (To be filled in by Planning and Development Staff only) <br /> Short Narrative of what you know about this situation, and any collateral information that <br /> you have obtained in this matter. <br /> (Include any specific request or suggestion that may be important to Staff who are working on the Assignment of the Rural Address) <br /> fic FY o L 4-. CSC /197 <br /> • <br /> Ji C/-FMP LL CJtgixaiui e J"homes <br /> 608 ■ 225■8194 <br /> JIM CAMPBELL KERRI CAMPBELL <br /> CUSTOM <br /> E-mail D E S I G N E D <br /> jcampbellsignaturehomes @charter.net a B U I L T <br /> H O M E S <br /> Staff person taking in this request s e 11 L. l.,J dC Jiel-t- <br /> Requestor shall provide a site plan, drawn to a measurable scale, including lot lines & lot <br /> dimensions, and any existing or planned ingress /egress to the property, and the distance <br /> from the lot lines to the ingress. <br /> Filed by Town & Section <br /> Form 2006- A 10-10-06 <br />