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bCPbC&24)(4--00005 <br /> Dane County Department of Planning & Development <br /> + Application for Density Study Report <br /> 41 <br /> Date: ///oAy <br /> Landowner information: <br /> Name: ..STUg,01. ,BOc1,R. <br /> Address: g'fo6 Gil i./ACA Pr,, R P City: e-2,OSS PLA-,NS Zip Code: 633 &2 <br /> Daytime phone: &OE-- 7qP-qcf3s" <br /> Fax: E-mail: C o!/e en low.?.0 yak)° , Gown_ <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 addresE /o(o UJ 04/ >NI,C,c Pr. /2 £ Cr D. 5 PL,1,A S(WT 5-3sa <br /> Parcel ID#: <br /> Legal description of property: <br /> 1/4 of 1/4. Section 3 a? Town of C I O$S Pf.,9f1JJ <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes ® No lJ <br /> Additional information (optional): <br /> Name of owner of original farm (if known): Do AML 0 Q OOJ,41 <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 U <br /> Don't know 0 <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 />