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DANE COUNTY <br /> APPLICATION FOR A CONDITIONAL USE PERMIT No. s� / <br /> The undersigned hereby applies for a conditional use permit for a <br /> an existing single family <br /> residence in the A-2 Agriculture <br /> District as provided for in 55 10. 126(2) (i) of the Dane County Zoning Ordinance. The <br /> property is located at 4617 Old Indian Trail in the Town of <br /> Vermont , more fully described as follows: <br /> Pet. #3875/551: <br /> Part of the E 1/2 SE 1/4 of Section 4 , Town of Vermont described as follows: <br /> Lot #1 , CSM 4103 found in volume 17 page 146 of Certified Survey Maps , <br /> Register of Deeds Office. <br /> I <br /> Respectfully submitted on t 198/ by: <br /> Owner: <br /> Agent: <br /> Name Name fiv //Vi <br /> Jd11n S /ca /sold <br /> Street Street Y� /7 O/'d <br /> Post <br /> Post /J office Office I/2C�C <br /> Telephone Zip Telephone 7‘ 3y4.7 Zip <br /> 545-59(11/79) <br />