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DANE COUNTY Zoning Division <br /> PLANNING DEVELOPMENT Room 116, City-County Building <br /> 210 Martin Luther King Jr. Blvd. <br /> Madison, Wisconsin 53703-3342 <br /> Zoning Change Application Phone: (608)266-4266 <br /> Fax: (608) 267-1540 <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 shall be shown on the drawing. The drawing shall include the area in acres or square feet. <br /> Owner's Name ; D , a e gent's Name emlfC4 F l� <br /> Address 41 sp QW n 4'I0 , f2 Address'50/0 `Town #11-11 2 t.O'#49 e <br /> Phone 1,0 2 I°/-€S 5 I CO`tf 1)e GIIOO,e id Phone <br /> 608--2/9. fIM//UGoo <br /> Email r�Al2r►1S yg30 Purn,i/•(Om crest /tile. CO/v1 <br /> V Email <br /> Town: NIP din Parcel numbers affected: Oa,/ -2 91 - g000 -2 <br /> Section: 01 Property address or location: 62'73 6,41< pg t 1144%1S1161.1, 14 <br /> Zoning District change: (To/From/#of acres) J) /-2 ( I ) A%tv(iV <br /> 4- ) El A -2 CI <br /> Soil classifications of area(percentages) Class I soils: % Class II soils: % Other:_ % <br /> Narrative: (reason for change, intended land use, size of farm, time schedule) <br /> Separation of buildings from farmland <br /> et. Creation of a residential lot <br /> 0 Compliance for existing structures and/or land uses <br /> O Other: <br /> I authorize that I am - owner od e .-• sion t. act on beh If of the owner of the property. + _/�^ O <br /> d /L <br /> Submitted By: ' � i � � Date: ` <br />