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J. Dane County Department of lad 6 a nen . <br /> Application for Density Study Report <br /> •a 5 JUN 3 2014 <br /> Di '-I fiI jf t 'V,N <br /> t &u V L.)PMENr Date: Z q M <br /> Landowner information: <br /> Name: LR 212,-.1 - N A-A S <br /> Address: _A 0 99 to 4),..)--r-,1 Ro City: 8/LJ e mo und3 Zip Code: .5 as-"1 <br /> Daytime phone: Go 4 317 q 'P4 <br /> Fax: E-mail: ' I • i . , ► . I ■ .A vaz-,,CAM <br /> Applicant information (if different from landowner): <br /> Name: <br /> Address: City: Zip Code: <br /> Daytime phone: <br /> Fax: E-mail: <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: Se e 20-b-Ca PR-∎ P■ 12 �� L'((a oF MoiAm'DS ( + <br /> Parcel ID#: 0 ( O ?n4-- 2U 7b - AAvAN6. ab• <br /> Legal description of property: <br /> f. L 1/4 of 9= 1/4, Section 20 , Town of 1-2k-t(.1-- MO v.(3 N) S <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No <br /> Additional information (optional): _ <br /> Name of owner of original farm (if known): L A A <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 /> YesO 0 <br /> Reg. of Deeds Doc.No. (if known) <br /> No <br /> Don't know (' <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 />