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ta <br /> ' Dane County Department of Planning & Development <br /> ` de. 1,9 Application for Density Study Report <br /> y K'. <br /> Date: 7-7- JLf <br /> Landowner information: <br /> Name: Ro best- 00.%.7-- <br /> Address: 95‘q 71.4,4 V (L, l2 City: ,$j os,ar;c. Zip Code: 53160 <br /> Daytime phone: 60 G?- 2.b.5-4? <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: Cogar DD iiz <br /> Address: ; (/.► j City: ,.?.want.(. Zip Code: 05GD <br /> Daytime phone: 60g- 76 7- GG/ <br /> Fax: E-mail: dor,z4,..1 ye fds. h01` <br /> Relationship to landowner: 504/ <br /> Are you submitting this application as an authorized agent for the landowner? Yes No <br /> Property information: <br /> Property address: 9515 SPn'.4.16 t/ffezzy go Attrio,K44,11g. 1,,!( S3s60 <br /> Parcel ID#: c9 O , -13`l- 95-00-g <br /> Legal description of property: <br /> 61 1/4 of 5£ 1/4, Section 13 , Town of /149►a42w.a4;e. <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes No ✓ <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 Reg. of Deeds Doc. No. (if known) <br /> No ✓ <br /> Don't know <br /> Comments: fre.fri J+ac �motef /TA ounS01P5- OF Rh1d FA N <br /> 7 IYAA2oiviwi . j io La ke -i0 8.1 lid new /i.m.* Dv. l08 keel I <br /> 14IA20.41aN?d ot.%f f(( <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 />