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Dane County Rezone & Application Date Petition Number Conditional Use Permit 10/14/2019 DCPREZ-2019 11486 Public Hearing Date C.U.P.Number 10/22/2019 OWNER INFORMATION AGENT INFORMATION OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area LAUFENBERG REV TR, ANTHONY P Code) BIRRENKOTT SURVEYING, INC Code) &ALYCE J 608133601 (608)837-7463 BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) 316 SLEEPY HOLLOW LN P.O. BOX 2371677 N. BRISTOL ST (City,State,Zip) (City,State,Zip) MARSHALL, WI 53559 Sun Prairie, WI 53590 E-MAIL ADDRESS E-MAIL ADDRESS jhk57 @charter.net bschilling @birrenkottsurveying.com ADDRESS/LOCATION I ADDRESS/LOCATION 2 ADDRESS/LOCATION 3 ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP ADDRESS OR LOCATION OF REZONE/CUP 5604 Box Elder Rd. TOWNSHIP I SECTION TOWNSHIP SECTION TOWNSHIP SECTION MEDINA 14 PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED 0812-143-9030-0 REASON FOR REZONE CUP DESCRIPTION SEPARATING EXISTING RESIDENCE FROM FARM, ZONING COMPLIANCE FOR SALE OF LAND TO ADJOINING OWNER, ZONING COMPLIANCE FOR REMNANT ACREAGE FROM DISTRICT: TO DISTRICT: ACRES DANE COUNTY CODE OF ORDINANCE SECTION I ACRES FP-35 (General RR-4 (Rural 4.7 Farmland Preservation) Residential, 4 to 8 District acres) District FP-35 (General RR-8 (Rural 8.0 Farmland Preservation) Residential, 8 to 16 District acres) District FP-35 (General FP-1 (Small Lot 12.6 Farmland Preservation) Farmland Preservation) District District RR-2 (Rural Residential, RR-8 (Rural 2.89 2 to 4 acres) District Residential, 8 to 16 acres) District C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S SIGNATURE:(Owner or Agent) REQUIRED? INITIALS ® Yes D No Yes ❑ No ❑ Yes No DJE1 Applicant Initials Applicant Initials Applicant Initials PRINT NAME: DATE: Form Version 03.00.03