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6e--k' bcA) - zoi5 _ booi <br /> ' g9Pe� <br /> V Q zr`.r� `t' v' Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> Date: -01i - Leit <br /> Landowner information: I <br /> Name: Of l,'a J• � /� tom/e b ra n cP C - <br /> Address: 4-95Z.. 8 e ' h City: e-r o 41,_ ' Zip Code: 35 <br /> Daytime phone: o g - .77 -77/4 <br /> Fax: E-mail: ti\hC'(IPfjre(0,14.€dcetivi.W�-ed�l <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 0 <br /> Property information: / <br /> Property address: /1/0 pq/'e e/` 41i e 55 a v4 i l 4 L/e <br /> Parcel ID #: rjo(oU SU �, 9� - ?07/-- D <br /> Legal description of property: �s J/ <br /> /V 1511/4 of .�L4-✓ 1/4, Section � , Town of (/:c,c,/�, r <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 C Reg. of Deeds Doc. No. (if known) <br /> No <br /> Don't know Q <br /> Comments: X Gt,o c/f li re to 5 �- !c Tl/,5 j04>'r a e_7 e Q ��- <br /> J 0 (, �e c i a//D - 5; I-€ c- rn./ h n <br /> O.„ c±r p N 1-71-1,e U r r' - 5 7( _ <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 />