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PLANNIN G.:- <br /> DANE COUNTY -. Zoning Division <br /> 4a _` - �, Room 116, City-County Building <br /> � � ,,. <br /> c?-1r _a1F�. 210 Martin Luther King Jr. Blvd. <br /> k Madison, Wisconsin 53703-3342 <br /> fir` ' ?s ®Wing Change Application Phone: (608) 266-4266 <br /> �a,a <br /> s'eo <br /> Fax: (608) 267-1540 <br /> Items that must be submitted with your application: <br /> 1 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 shall be shown on the drawing. The drawing shall include the area in acres or square feet. <br /> Owner's Name kose_m a{y m QrdP n v n1,4,Actai Pi ±Z Agent's Name <br /> Address 6, Old S-6 5e,, (Oo S-ir-u hI n li21 Address <br /> Phone ` '3 58 01 Phone <br /> 6oga19 419'1 60$' & 3arp2O <br /> Email Email <br /> f o se.,(Q,lice u)i red. Aet <br /> Town. Rut,a n d Parcel numbers affected: I b 5 /0 36 /- 9 6 °l o - f <br /> Section: 01 Property address or location: a 6 Mat at S- N. oa <br /> Zoning District change: (To/From/#of acres) RH- 1 t-rc m Ai E <br /> Soil classifications of area (percentages) Class I soils: % Class II soils: % Other.J 00 <br /> I f <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> 0 Separation of buildings from farmland <br /> O Creation of a residential lot ' <br /> O Compliance for existing structures and/or land uses <br /> D Other: <br /> to have. 0.AImc< Is . <br /> I authorize that I am the owner or have permission to act on behalf of the owner of the property. <br /> Submitted By: 39jyy.iCL • Ncti\ Date: 1/I O G <br /> 1 Ni <br />