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III <br /> 1 DANE' CouN�Y ,_ Zoning Division <br /> i iNq t; v L PME T Room 116, City-County Building <br /> tea` 3.,. =..- • 210 Martin Luther King Jr. Blvd. <br /> f U,4'17:;_� Madison, Wisconsin 53703 3342 <br /> � ; rt ')' Phone: 6W Wisconsin 5 <br /> ? sco.5.' Change Application Fax: (6 8) 267-1540 <br /> ti <br /> ■ <br /> Items that must be submitted with your application: <br /> o 'Written Legal Description of the proposed Zoning Boundaries 1 <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 /> II <br /> Owner'Name -�^ 1 Agent's Name Lc, h. ...,,\ .,,c:, 1, <br /> { tt -3- -X- Address �C? �� � [Itr�ST ���� �..�tt�y'` II <br /> Address `�tf�� �� Owl.; ti�`�.t� ' I.......0-- . `�'�t: I. <br /> ' �•Ct ;� ,`"'1 — '3 ' Phone 6e� - Y '4'> " '779.) <br /> Phone <br /> Email I - ✓ Email /ism. ', ' . .-2; C7' E1-' -- <br /> I j <br /> Town. V 1',1"�d l� l Parcel numbers affected: d70r0 '-I.31 - $000-0 /n 7D Co-131 -q.�`�v' 3 <br /> 1 Property address or location: e ygy fle T7 l� A 4trt,, :. T,-§` <br /> 1 <br /> Section: ,fit ( � P �' /r <br /> i Zoning District change: (To/From/#of acres) i(r� 10' r R\'�\ / Z. 11 <br /> ■ I <br /> Soil classifications of area(percentages) . Class I soils: % Class II soils: % Other._ % 1 <br /> i <br /> 1 i <br /> 1 <br /> Narrative: (reason-for-change,-intended-land use,-size-offarm-time-schedule)--- ---- '- <br /> 0 Separation of buildings from farmland <br /> ,1g1; Creation of a residential lot - <br /> 0 Compliance for existing structures and/or land uses 1 <br /> i, <br /> 0 Other: <br /> 1 . <br /> �j <br /> I <br /> i <br /> 1 <br /> // p <br /> 1 authorize that I am wn have permission to o f of the own property. Date: ���l��`� <br /> Sub fitted By: �� � �. <br /> i . <br />