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Dane County Rezone & Application Date Petition Number <br /> 11/04/2016 DCPREZ-2016-11077 <br /> Conditional Use Permit Public Nearing Date C.U.P.Number <br /> 01/24/2017 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> SCOTT M BRICKL Code) Code) <br /> (608) 643-6074 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 8637 MACK RD <br /> (City,State,Zip) (City,State,Zip) <br /> SAUK CITY, WI 53583 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> brickltrklkg@wildblue.net <br /> ADDRESS/LOCATION 1 ADDRESS/LOCATION 2 ADDRESS/LOCATION 3 <br /> ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP <br /> 8637 Mack Rd 8637 Mack Rd <br /> TOWNSHIP TOWNSHIP SECTION TOWNSHIP SECTION <br /> ROXBURY 'SECTION <br /> 15 ROXBURY 15 <br /> PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED <br /> 0907-152-8070-5 0907-152-8130-0 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> SHIFTING OF PROPERTY LINES BETWEEN <br /> ADJACENT LAND OWNERS <br /> FROM DISTRICT: TO DISTRICT: ACRES DANE COUNTY CODE OF ORDINANCE SECTION ; [ ACRES <br /> A-1 Ex Exclusive Ag RH-1 Rural Homes 0.45 <br /> District District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S INITIALS SIGNATURE:(Owner or Agent) <br /> REQUIRED? <br /> Yes ❑ No ❑ Yes No ❑ Yes ® No gi:e./(1�//�7 SSA1 <br /> Applicant Initials --CO'%!i' Applicant Initials �:/ Applicant Initials Sig PRINT NAME: <br /> SCD-tt m I3ri L <br /> DATE: <br /> /(- y / <br /> CSM/DOC: y y Q a/t- Q� Form Version 03.00.03 <br /> 1 L� <br /> DEED RESTRICTION: <br /> DEED NOTICE: <br /> OTHER: <br />