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PL7 2(D f5 -- Z <br /> O Z <br /> Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> 'a3., <br /> ACi <br /> Ock <br /> Date: 9) co/5" <br /> Landowner information: <br /> Name: E k ox k Fa_. �, C � C v f 01.1 <br /> Address: , - A , City: t k v rl 2, Zip Code: S 3 3-0g <br /> Daytime phone: , L/ 3e, `- <br /> 3g- — 5 3b a c_..,1.I <br /> Fax: E-mail: (f..f n e dkbi <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: Co I b (\of , l(6 3 Svc <br /> Parcel ID #: <br /> Legal description of property: <br /> OR 1/4 of 1/4, Section , Town of ` '11�,�0-foS.e __at <br /> Certified Survey Map ID: Lot �' <br /> Sketch map provided? Yes 0 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 0 ® Reg. of Deeds Doc. No. (if known) <br /> No <br /> Don't know e' <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 />