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fti� <br /> es, Dane County Department of Planning & Development <br /> aa', Application for Density Study Report <br /> 4COSS <br /> Date: S 1\s1v-\ <br /> Landowner information: <br /> Name: <br /> Address: City: Zip Code: <br /> Daytime phone: <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: <br /> Address: "180 y City: (\��.ccwl Zip Code: 635h <br /> Daytime phone: -aob- `fl 6 <br /> Fax: b-3q\-acg0 E-mail: .AN«tc\ .v,e� <br /> Relationship to landowner: tzN azt,\k_ \ham \t3 \.c\ c. \Nov�Se <br /> Are you submitting this application as an authorized agent for the landowner? Yes No ✓ <br /> Property information: <br /> Property address: e15F5 4,1/4.)., H��j1�..�, \N'��1 �o S ©SErJcn <br /> Parcel ID#: C -t \OWA 3■01 aa� <br /> Legal description of property: <br /> k\ ME 1/4 of 5E 1/4, Section v3-5-1, Town of Oceoloc <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: t. ,5 �,�\ .,y:. \ne .)-�>c\ �o \p�,:,� o v.ce- Sol ,ae <br /> - o " .r�\ c5v�"� �c-,pv� �Mat�.� AS n-ke t�\ C•Nc ‘ct`A. \ham -N\c-VN <br /> c-04\ b.�.\�. �s � or\ <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 />