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O <br /> Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> 1 4 <br /> sCO s' <br /> December <br /> Date: 14, 2015 <br /> Lame: iodd J Meinflolz n: <br /> Name: � <br /> Address: 1640 US Highway 12 And 18 City: Deerfield Zip Code: 53531 <br /> Daytime phone: 608-358-2269 <br /> Fax: Email: tmeinholz8Cyahoo.com <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: 1640 US Highway 12 And 18 <br /> Parcel ID#: 018/0(11-361-8001-U and 018/0/11-361-8b00-6 <br /> Legal description of property: <br /> 1/4 of 1/4, Section ,Town of C011& Cleve- <br /> OR J <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No 0 <br /> Additional information (optional): Unknown <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 411 Reg. of Deeds Doc. No. (if known) <br /> No 0 <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 />