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Pr. <br /> -.\ <br /> ` Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> iF <br /> Date: 18 C ) h� 201 <br /> Landowneq information: , <br /> Name: h h Z l.(G l+ <br /> Address: 5p �nl, H u d s(,� �-(- / CityjWq py viz c 1p Zip Code: 3 6-0 <br /> Daytime phone: /08 -- 79 5 —Ljl'zg g <br /> Fax: N 7A E-mail: Sz U Z , , - <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 address: <br /> Parcel ID#: 06/D/,_ C. 41dOO6. o R06363etsooq t 806, 10:.#915'OZ <br /> 04106638500 pgO6olz$000Z <br /> Frs} 3e5 cc.cllr <br /> Legal description of property: <br /> 1/4 of 1/4, Section , Town of <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No 0 <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 O Reg. of Deeds Doc. No. (if known) <br /> No <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 />