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,iisabgN°.10/3-a00 <br /> ` Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> '000 <br /> Date: /a /81/3 <br /> DEC 2 <br /> 2013 <br /> Landowner information: <br /> Name: .5`t r:Ve d/ L 6 O a R 2 <br /> Address: 1,410 6 tV' /yl/N/W t. PTAPCity: Gtitoss 0.-41//v.3 Zip Code: 6-35-a& <br /> Daytime phone: (.70.$- `/`/35 <br /> Fax: E-mail: C o((2Qn bow-cue-@ y a.-Lio0 1 co ill <br /> Applicant information (if different from landowner): <br /> Name: <br /> Address: City: Zip Code: <br /> Daytime phone: <br /> Fax: E-mail: c 0I/Q2v1 bov.air-@ ya 400 ((Mk <br /> Relationship to landowner: <br /> Are you submitting this application as an authorized agent for the landowner? Yes 0 No ® <br /> Property information: <br /> Property address: L/�1 U) . /'Y1 //1.11V/11.. P T. ,2 G 12 0S$ PAM/NS, wI• 5•3 2 as2 <br /> Parcel ID#: <br /> w% of MI) 4 sue, AS-7. - 55 % of ,vEJ skc.A6 - a %aF b( 511e.— ac <br /> Legal description of property: <br /> ,/ 1/4 of kg 1/4, Section 025''?-7 Town of C (20s5 QL,y/pS <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 . No 0 <br /> Additional information (optional): <br /> Name of owner of original farm(if known): LEST-13R PAI R E/L EST, <br /> T <br /> Are there any recorded agreements, liens,deed restrictions, easements or other legally binding <br /> documents that would affect the number or distribution of potential building sites on the property? <br /> Yes 0 © Reg. of Deeds Doc. No. (if known) S041114/7 <br /> No <br /> Don't know •0 <br /> Comments: <br /> Please allow 3-6 weeks to process your request. A copy of the report will be mailed to the landowner, <br /> the applicant(if different from the landowner)and the town clerk. <br />