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Dane County Rezone Petition Application Date Petition Number <br /> 03/12/2021 <br /> Public Hearing Date DCPREZ-2021-11691 <br /> 05/25/2021 <br /> OWNER INFORMATION AGENT INFORMATION <br /> OWNER NAME PHONE(with Area AGENT NAME PHONE(with Area <br /> ADAM LEE CARRICO Code) WILLIAMSON SURVEYING AND Code) <br /> (608)213-9718 ASSOCIATES (608)255-5705 <br /> BILLING ADDRESS(Number&Street) ADDRESS(Number&Street) <br /> 1926 N KOLLATH RD 104A W MAIN ST <br /> (City,State,Zip) (City,State,Zip) <br /> VERONA, WI 53593 WAUNAKEE, WI 53597 <br /> E-MAIL ADDRESS E-MAIL ADDRESS <br /> adam@carricoengineering.com noa@williamsonsurveying.com <br /> ADDRESS/LOCATION 1 ADDRESS/LOCATION 2 ADDRESS/LOCATION 3 <br /> ADDRESS OR LOCATION OF REZONE ADDRESS OR LOCATION OF REZONE ADDRESS OR LOCATION OF REZONE <br /> East of 8191 County Hwy G <br /> TOWNSHIP SECTION TOWNSHIP SECTION TOWNSHIP SECTION <br /> SPRINGDALE 25 <br /> PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED PARCEL NUMBERS INVOLVED <br /> 0607-253-8500-8 0607-252-9360-7, 0607-253-9000-1 <br /> REASON FOR REZONE <br /> CREATING THREE RESIDENTIAL LOTS <br /> FROM DISTRICT: TO DISTRICT: ACRES <br /> AT-35 Agriculture Transition District SFR-2 Single Family Residential District 6 <br /> AT-35 Agriculture Transition District RM-8 Rural Mixed-Use District 68.23 <br /> C.S.M REQUIRED? PLAT REQUIRED? DEED RESTRICTION INSPECTOR'S SIGNATURE:(Owner or Agent) <br /> REQUIRED? INITIALS <br /> ® Yes ❑ No ❑ Yes ® No ® Yes ❑ No <br /> RWL1 <br /> Applicant Initials Applicant Initials Applicant Initials PRINT NAME: <br /> COMMENTS: <br /> 1. AREAS OF THE PROPERTY MAY BE WITHIN THE SHORELAND <br /> DISTRICT DUE TO POSSIBLE INTERMITTENT STREAMS ON <br /> PROPERTY. NAVIGABILITY DETERMINATION ADVISED. DATE. <br /> 2. THE DEVELOPMENT FRONTS ON COUNTY HWY G. PROOF OF <br /> HIGHWAY ACCESS REQUIRED. <br /> 3. LOW AREAS OF PROPERTY HAVE A HIGH WATER TABLE. <br /> Form Version 04.00.00 <br />