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all ' a <br /> O r,•0, ' `"� Dane County Department of Planning & Development <br /> '. Application for Density Study Report v , <br /> :may <br /> ..C <br /> R t <br /> Date: r/Lf---7.5- r,g wPM <br /> , o <br /> Landownw information: �p CCI�, <br /> Name: L GE I G E i Code: ; ` <br /> Address:L550_ DEL 3 A/ 9 9 5ity:L/g S VE G 1.9' p <br /> Daytime phone: "L ,� } <br /> Fax: A/0 NE E-mail: /VO,VE <br /> Applicant information (if •ifferent from I n owner): <br /> ? <br /> Name: /U , Zip Code: S q <br /> Address: ► I r I . <br /> V <br /> 1 .; <br /> Daytime one: , i - r ■ �' ��n <br /> Fax: p a i - - 1 E-mail: a r r _ <br /> Relationship to lan•owner: are)�°�- No <br /> Are you submitting this applications an authorized agent for the landowner? Yes <br /> Property information: ` ' w , is, <br /> Property address: ► .d A A 1 h� I ' -� / <br /> Parcel ID#: 06,2_ 0 OS -2 9 - 7560 1f <br /> Legal description of property: ,, // <br /> 5!_= 1/4 of 5 j/1/4, Section Z '6 U(.�1 <br /> , Town of l>tot <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No <br /> 0 <br /> Additional information (optional): ONL �� E <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 el <br /> Don't know (!) <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 /> i <br />