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• <br /> DANE CouN-Y Zoning Division <br /> — Y::_ �.0 ' _ :,. Room 116, City-County Building <br /> c°`;'' aF� ` 210 Martin Luther King Jr. Blvd. <br /> '� Madison, Wisconsin 53703-3342 I' <br /> 1,:k.:,-;7j,:,., ®ping Change A�p9i���i®n : ( ) <br /> rata Phone 6W Wisconsin <br /> 5 <br /> 266-4266 <br /> seo•; <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 /> ' <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 /> I' Owner's Name TH ik�ER E _ Ev Efzi Agent's Name <br /> i <br /> Address 51Q Address <br /> Phone S Vo'J& HTO IV (OT 5-3 SFrQI Phone <br /> 670/5' — gA 9 - Z $3 1 <br /> Email .@ cr , _Q I Email <br /> Town. DtAmJ ayrlf--.. Parcel numbers affected: 05/l ^ 3o `/ ` 70ehi " a <br /> Section: 01 Property address or location: &R' - Sid...-1-e_ 141 1 3$ <br /> Zoning District change: (To/From I#of acres) 14' 2 C a-) /1 J'.t.* Z ' 8t ht <br /> 1 <br /> . <br /> i <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 /> O Separation of buildings from farmland <br /> O Creation of a residential lot <br /> O Compliance for existing structures and/or land uses <br /> 0 Other:D l' <br /> K2_2_e Nf._ p0 r o -r Co r • 50\racy 2 / c \ <br /> k '' <br /> Ces r.d\i-t 0 NcAA u5-•2_ ts2.c-w• *" -Far S-1-o r-a-c, <br /> I authorize that 1 am the owner or have i ion to a on beh of the owner of the property. "d�"7 <br /> Submitted By: Date: <br />