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c,ro,w - ?af 6 - aoo12 - <br /> 0, r 0 Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> 18.9 <br /> aaus <br /> & °. 1VS <br /> Date: 17 I41 <br /> . <br /> Landowner information: ( p Q <br /> Name: 4.5kt4 1 9. M oD re 1 LGi.Ie �F /4 , t 6"0 re <br /> Address: 3 ? 5 Ira tott,-- i t City: (Wd(1e�✓t Zip Code: 53 562 <br /> Daytime phone: (p$-A 17- J 2.5 <br /> Fax: _D5- E-mail: ' <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: <br /> Parcel ID#: &at- 2 8(--gOC1)-- 3 <br /> Legal description of property: <br /> S W 1/4 of 1J6 1/4, Section,Z 'i'Town of BeC'(y <br /> OR / <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 Q <br /> 1 <br /> Comments: Nei tied Sri trf d.-� 6keet i e_a-Tbns. O&tP t s r • <br /> ., i <br /> Opp . vO• - �' •, ■�._- .r O .• �" - . •r - <br /> "�• ponsi 6b u.r,c .L& tilce eonskdece•' �q� -Nrt <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 />