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DANE COUNTY Zoning Division <br /> PLANNING, <br /> .;pcp; t DEVELOPMENT Room 116,City-County Building <br /> .' ,• r,, 210 Martin Luther King Jr. Blvd. <br /> Madison,Wisconsin 53703-3342 <br /> ,, k u 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 GA w Le�,e r 9)z Agent's Name <br /> Address ( Address <br /> Phone G' 23.0 ' `/696 Phone <br /> Email G,ieve.r i23 e HGL . COtr) Email <br /> Town. OV'e jOh Parcel numbers affected: <br /> Section: 01 Property address or location: <br /> Zonin District change: (To/From/#of acres) i i I- <br /> 1 • ► u. ..1 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 /> 4 Creation of a residential lot <br /> ® Compliance for existing structures and/or land uses <br /> O Other: <br /> (\GR.\cvV'l�RA�RaavCC1o,- (,SPA S ) r &\w5) <br /> I authorize that I am the owner or have permission to act on behalf of the owner of the property. <br /> Submitted By: Date: <br />