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Olt <br /> 1CPb£1J-206- 0o01 3 <br /> 611 ' <br /> _ b RC-�k -701 085r <br /> 0 . �` `� <br /> S <br /> Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> X"39. <br /> M 01) Ct4t <br /> Date: -D7-(S <br /> Landowner informati n: (o judf <br /> Name: Pc,JG=ice- j-(U•pSibp/j ,r^ <br /> Address: 7q05 3ZE E r , 1 g() City: 51-0i( Ci r l Zip Code: 33 T, L.- --e <br /> Daytime phone: - 73.679, <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: L� H ELL,1=%-13k A-0 <br /> Address: 7(v5- t4u i i V City: L.-C J% Zip Code: 53 5 5 S' <br /> Daytime phone: ( c A :35.).,/ <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: r"1I <br /> Parcel ID#: C_NEi3 <br /> Legal description of property: 1 <br /> 1/4 of 1/4, Section 11 , Town of Del-•J a- <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes er No `1► <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: rLs4 r ��,- `J �y I 0 D;✓r v c10 4C /4,,J0 <br /> ■A.OLILl7 Kt'- , 4( if l7Enls7 U ,T Tv OAJF <br /> Nk,.Li r �' !6i 'd <br /> S r�>rL ;�`iSr f �l�w t�i i'c I 7 r1i <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 />