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Dane Coun ty Department of Planning & Development <br /> jr <br /> Application for Density Study Report RECEIVED <br /> 451C 614 <br /> JAN 8 2016 <br /> 01/05/16 <br /> Date: DANE COUNTY PLANNING&DEVELOPMENT <br /> Landowner information: <br /> Name: Patrick M Buchholz <br /> Address: 5216 Black Walnut Dr City:MnParlanri Zip Code: 5355R <br /> Daytime phone: 608-575-0380 <br /> Fax: E-mail: patb(c sharedmed.-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: 2045 Ctv Hwy BB Cottage Grove WI 53527 <br /> Parcel ID#: 071111385908 /071111381902 /071111292508 / 0711104800002 <br /> Legal description of property: Cottage Grove <br /> 1/4 of 1/4, Section , Town of 9 <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No 0 <br /> Additional information (optional): Goodman <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 O Reg. of Deeds Doc.No. (if known) <br /> No <br /> Don't know O <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 />