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Dane County Rezone & Application Date Petition Number <br /> Conditional Use Permit 03/13/2019 DCPREZ-2019-11418 <br /> Public Hearing Date C.U.P.Number <br /> 05/28/2019 <br /> OWNER INFORMATION AGENT INFORMATION <br /> i <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> SKI LANE PROPERTIES LLC Code) TOM JACOBS Code) <br /> (608) 220-7777 (608) 220-7777 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 2740 SKI LN 812 E DAYTON ST#1507 <br /> (City,State,Zip) (City,State,Zip) <br /> MADISON, WI 53713 MADISON, WI 53703 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> TOMJ @JTHOMASJACOBS.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 /> 2733 SKI LN <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> MADISON 35 <br /> PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED <br /> 0709-354-9940-6 <br /> REASON FOR REZONE CUP DESCRIPTION <br /> CHANGE OF ZONING TO ALLOW FOR MATCHING <br /> ZONING ON ADJACENT PARCELS UNDER SAME <br /> OWNER <br /> FROM DISTRICT: TO DISTRICT: ACRES DANE COUNTY CODE OF ORDINANCE SECTION ' ACRES <br /> RH-1 Rural Homes C-1 Commercial District 1.5 <br /> District <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S SIGNATUR • w er or Agent) <br /> REQUIRED? INITIALS <br /> ❑ Yes ® No ❑ Yes ® No ❑ Yes ® No <br /> (6 _ <br /> HJH3 _ <br /> Applicant Initials Applicant Initials - Applicant Initials x PRINT NAME: <br /> (0 C(Cc, / ✓) <br /> DATE: <br /> SEE _..3 0 ,. <br /> lc) <br /> F rm Version 03.00.03 <br /> REVISED <br />