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. Dane County Department of Planning & Development <br /> ' 4a Application for Density Study Report <br /> aCoita <br /> Date: V/?//to' <br /> Landowner information: <br /> Name: a ye.0 I1 s �a ei 14 0 A%n1 <br /> Address: 96o Pres/dem tr:►1 1.-A,City: t4 a.o/S o nl Zip Code: -S3 71 I <br /> Daytime phone: <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: M4vk NO✓'/ Mrj F(%,"51-- Mi <br /> Address: 207 Al' g v-h .$ - City:/1/11: Horeb Zip Code: 5'3572 <br /> Daytime phone: 6 Dcsi- 5 7 5 3 3 9 3 <br /> Fax: , , . - - • E-mail: 0 r I 9 - M I1]-C . h <br /> Relationship to landowner: q ye, r. 1 es 102111717 Co 1'i i r qC <br /> Are you submitting this application as an authorized agent for the lando, ner? Yes • No a <br /> Property information: /` <br /> Property address: 9 d 3 .1 G ' / S' ../07'-. r/'eke <br /> Parcel ID#: 06,07- 05/- 8001-a� 0 60 7 - OS/- 8530-0, d &C7-O5/ ?c6/ <br /> 0607-- 0Si gcoo--p 0 6 0'7 - O s ). - <br /> Legal description of property: <br /> 1/4 of 1/4, Section , Town of -Seri i1 p doh f e <br /> OR J <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes No O <br /> Additional information (optional): l-J <br /> Name of owner of original farm (if known): /r4 h SO Ai <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 <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 />