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DANE COUNTY <br /> APPLICATION FOR A CONDITIONAL USE PERMIT No. ce Z3 <br /> The undersigned hereby applies for a conditional use permit for a <br /> Single family residence in the A-2 Agriculture <br /> District as provided for in SS 10. 126(2) (i) of the Zoning Ordinance. The <br /> property is located at E. of 8039 Crystal Lake Rd.in the Town of <br /> Roxbury , more fully described as follows: <br /> C.U.P. #623: <br /> Part of the NW 1/4 SE 1/4 Section 1, Town of Roxbury described as follows: <br /> Lot #1, CSM 2765 found in Volume 11, Page 67 of Certified Survey Maps, <br /> Register of Deeds Office. <br /> I <br /> I <br /> Respectfully submitted on 9— [ 187by: <br /> Agent: Owner: <br /> Name Name y--- ' " te_emj <br /> me - L,-,S -- F C <br /> Street Street 75,0c, gzEC)/V? C7 i24) - <br /> Post Post <br /> Office ,Ckg- C /T" LL)nfficc f <br /> Telephone Zip Telephone6VP- 43-4? 74) <br /> 545-59(11/79) <br />