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� <br /> ( -2015 `000Z <br /> Dane County Department of Planning & Development <br /> ,ih ' 1 ' Application for Density Study Report <br /> 1A <br /> 6'c[>' -S. <br /> Date: 6112i/2.01c <br /> Landowner information: <br /> Name: DA,1)1e 1 . 1D-r Mnc i o <br /> Address: 1313 cif-r,,4 5reze-r City: New GLAp.vs Zip Code: 5-35-74► <br /> Daytime phone: 6,o8-2,71-71c2 <br /> Fax: E-mail: oiotmctj2;o Si c ie.;/.co- <br /> Applicant information (if different from landowner): (/ � <br /> Name: Mfot RE,tetL <br /> Address: 1'5-i W, Wo_sck) Sr- cum: 12e i City: ivt,tptsv,v Zip Code: 5-3703 <br /> Daytime phone: Up13.- 251. 1SZIo <br /> Fax: 6oS -2V I- 701 E-mail: rna.x a rnaS1 .1 , Ca'? <br /> Relationship to landowner: f}}1o, <br /> Are you submitting this application as an authorized agent for the landowner? Yes ,)( No <br /> Property information: <br /> Property address: 579 STATE naot/itny 78 <br /> Parcel ID #: o v,-Zo-s-gioo-S ; Mk-lit-_S000-o . Osob-z -9Soo-c, cc -292-9soo-3; OSOl.-?DI-1Pdoa-8 <br /> Legal description of property: Ste. 0.t►ucli.„,1 <br /> 1/4 of 1/4, Section , Town of <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) 1-19691/Q <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 />