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DANE COUNTY <br /> APPLICATION FOR A CONDITIONAL USE PERMIT No. -4-1-R <br /> The undersigned hereby applies for a conditional use permit for a <br /> Diagensing of motor vehicle in the - Comm rria1 <br /> fuels <br /> District as provided for in ss 10.14 (2) (cOf the Zoning Ordinance. The <br /> property is located at 3439 USH 12-18 in the Town of <br /> Blooming Grove , more fully described as follows: <br /> Part of the Ell NE; of Section 26, Town of Blooming Grove described as follows: <br /> Lot #5, Assessor Plat #10, Town of Blooming Grove. <br /> AUG 2 7 1985 <br /> Respectfully submitted on . 2i 1g3by: <br /> Agent: / Owner: <br /> Name e(� 2/(1,71)�✓ <br /> Name 2 <br /> /v- `J eic4 <br /> /(4%;,C <br /> Street Street /- F7' -S7` <br /> Post Post <br /> f <br /> Office Office `5l'/f) PrX//c/ (/t/i ` <br /> Telephone Zip Telephone F_3 77 / .'.ip �3 S 9 0 <br /> 545-59(11/79) <br />