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Dane County Rezone & Application Date Petition Number <br /> 11/29/2016 DCPREZ-2016-11083 <br /> Conditional Use Permit Public Hearing Date C.U.P.Number <br /> 02/28/2017 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> BEGHIN LIVING TR, DONALD L& Code) Code) <br /> MARIAN M (608) 832-4413 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 8853 COLBY RD <br /> (City,State,Zip) (City,State,Zip) <br /> MT HOREB, WI 53572 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <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 /> WEST OF 8853 COLBY ROAD <br /> TOWNSHIP TOWNSHIP SECTION TOWNSHIP SECTION <br /> PRIMROSE 'SECTION <br /> 4 <br /> PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED <br /> 0507-042-8590-7 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> CREATING ONE RESIDENTIAL LOT <br /> FROM DISTRICT: TO DISTRICT: ACRES DANE COUNTY CODE OF ORDINANCE.SECTION ! ACRES <br /> A-1 Ex Exclusive Ag RH-1 Rural Homes 3 <br /> District District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTORS INITIALS SIGNATURE:(Owner or Agent) <br /> REQUIRED? <br /> ❑ Yes No ❑ Yes ® No ❑ Yes ® No //WV/Oa/6 <br /> PMK2 <br /> Applicant Initials Applicant Initials Applicant Initials PRINT NAME: / <br /> COMMENTS: REZONE TO CLEAR UP ZONING CATEGORY. ©p h /cf �, ' eyd/0 <br /> DATE: <br /> //— - <br /> CSM/DOC: <br /> Form Version 03.00.03 <br /> DEED RESTRICTION: 531 2175B6, <br /> DEED NOTICE: 531 wRg'—j <br /> OTHER: <br />