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DANE COUNTY Zoning Division <br /> Room 116, City-County Building <br /> air. r <br /> • 210 Martin Luther King Jr. Blvd. <br /> rt Madison, Wisconsin 53703-3342 <br /> Zoning Change Application Phone: (608) 266-4266 <br /> 1919 <br /> seo <br /> Fax: (608) 267-1540 <br /> • <br /> Items that must be submitted with your application: <br /> o Written Legal Description of the proposed Zoning Boundaries <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 sr. . shown on the drawing. The drawing shall include the area in acres or square feet. <br /> I I Owner's Name' t r / Agent's Name <br /> Address # 5 5 f?idress <br /> Phone v Phone <br /> - __ or Vj/i1/4;/AW• `Email 0rkk �r Email <br /> • Town' / € Parcel numbers affected: d ■77t" 5s 1 -0 <br /> 90* - /z ,/- *6b0- <br /> Section / Property address or location: (o �$c��CZ/�� � f�►, <br /> Zoning District change: (To/From/#of acres) f/. f c'Sl r' //CSi - 7'c R l7 <br /> Soil classifications of area (percentages) . Class I soils: % Class I I soils: % Other._ % <br /> -'—Narrative:-(reason-for-change,-intended-land-use size-of-farm,-time-schedule)-- --- - - --- <br /> Separation of buildings from farmland <br /> gi Creation of a residential lot _ <br /> 0 Compliance for existing structures and/or land uses <br /> 8 Other. <br /> 7c�S/.. .6/L1�/l9L G t� `�' l� I7 AZ �'se Ste/ <br /> 71716� r S?5 P 93 x cfr <br /> • <br /> • <br /> I authorize t - o 1-•1-• -;4e n to act on • :If of the owner of the property. _ <br /> I Submitted 0 n <br /> Date: �� <br /> • <br /> : ,�, <br />