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-DPDCA aof5 - oa0 <br /> a <br /> Dane County Department of Planning G1Th ent <br /> Application for Density Study ort 1) <br /> Nog 1 <br /> +'ltotA5 Mai <br /> NAG&0�,0� <br /> Q�N <br /> Date: S-15- IS t"``etc <br /> Landowner information: nn __ <br /> Name: TU..✓1, -e, ''C.D&d VYI , L_L C. C/O 1O n <br /> Address: P.O. n City: (Yr.tdL�Ur1 Zip Code: 5 106 <br /> Daytime phone: (pd -57(0 <br /> Fax: E-mail: b han i_d @ S, ne t <br /> Applic- I t information Of differ, from Ian•owner : <br /> Name: • /__, cX'C.t e-� e I , 4 ���r tA-CtZ <br /> Address: G?j}��iMIK. City: A • Zip Code: <br /> Daytime phone: (aD R- CI -I—7'7( <br /> Fax: (r,0SS -7GS -a O7 E-mail: l e.,- OtIS+►- _G ) I t*In i I. CCYV\. <br /> Relationship to landowner: 3 elnerra Ctirch-6.-MW <br /> Are you submitting this application as an authorized agent for the landowner? Yes ® �� <br /> Property information: ? <br /> Property address: • <br /> Parcel ID#: 0O4- 0g0- '3Oa-85c D -'--I' <br /> Legal description of property: <br /> 1/4 of 1/4, Section , Town of <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): <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) <br /> No <br /> Don't know • (� <br /> Comments: pot 51(5 (.4 l l,'( 19. klutt on� Cam# <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 />