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Dane County Rezone & Application Date Petition Number <br /> Conditional Use Permit 06/20/2019 DCPREZ 2019 11459 <br /> Public Hearing Date C.U.P.Number <br /> 08/27/2019 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> BRENT BRATTLIE Code) JIM HAAK Code) <br /> (608) 235-9317 (608) 712-7915 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 4107 BANNON RD 3863 AMBER LN <br /> (City,State,Zip) (City,State,Zip) <br /> MARSHALL, WI 53559 DEERFIELD, WI 53531 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> JENNHABS @MSN.COM JIMHAAK93 @GMAIL.COM <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 /> 4107 BANNON RD <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> DEERFIELD 14 <br /> PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED <br /> 0712-142-9690-8 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> CREATING ONE RESIDENTIAL LOT <br /> FROM DISTRICT: TO DISTRICT: ACRES DANE COUNTY CODE OF ORDINANCE SECTION I ACRES <br /> FP-35 (General RR-2 (Rural 2.0 <br /> Farmland Preservation) Residential, 2 to 4 <br /> District acres) District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S SIGNATURE:(Owner or Agent) <br /> REQUIRED? INITIALS <br /> 9 Yes No Yes ® No Yes ® No <br /> � <br /> �/ SLJ3 <br /> / 1 <br /> Applicant Initiar Applicant Initial/'" Applicant Initials/1 PRINT NAME: <br /> DATE: <br /> Zo ?°./ 9 <br /> Form Version 03.00.03 <br />