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v'e Dane County Department of Planning & Development <br /> • <br /> tft <br /> Application for Density Study Report <br /> 1fI�� <br /> d <br /> Date: [-/7-I-I'D <br /> Landowner information: <br /> Name: bale a.,,,( J od(.i 3O L Sow <br /> Address: 9 5 so 6reeP_ 1j. City:\ij nrr tr\-1-0 Zip Code: 2_ 01e6 ,\;A <br /> Daytime phone: <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: D O r\D\l a" -o k v\SO,-. <br /> Address: 153 Lee w rl I a ne, City: Ore30,-, Zip Code: 5 35 7 S <br /> Daytime phone: (Dpt9 83S-- 1 z <br /> Fax: E-mail: <br /> Relationship to landowner: "3 R0-i-in-e r <br /> Are you submitting this application as an authorized agent for the landowner? Yes 0 No <br /> Property information: <br /> Property address: /8l ON,,,, 1--41 . ' 'Z /cci.., tr". S.3-C 4-1 <br /> Parcel ID#: a -O • 3S :1 • rr DO <br /> Legal description of property: <br /> 1/4 of 1/4, Section3A(, Town of CeQ"jn") <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): .,,,,a"(./ <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: o - !2S - '. 1ACZs (c Orr 1IL) <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 />