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66, - 00-0 14_ <br /> Dane County Department of Planning & Devege <br /> CEIVED <br /> Application for Density Study Report <br /> a MAR 2 1 2016 <br /> Date:/Y14 k !-/I 3l SAY 4 DANE COUNTY PLANNING&DEVELOPMENT <br /> Landowner information: <br /> Name: f try f 1 . /1. L C{ F i/6/? <br /> Address: 5 '/ MAO s iv Cue City: 0 2FG 0w Zip Code: 5 3 5-7 S <br /> Daytime phone: f.,Gd k 3 5 3cc <br /> Fax: 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: 5'5 e .r Ltd /If t-T 12(A)oo A 7 ) 11) - 3 S 7..1- <br /> Parcel ID #: 0 5 D 9 - o L/ '- - O <br /> Le al description of property: <br /> ivce A C 1/4 of 5f- 1/4, Section Town of o e" Co 0,4/ <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): � PI,h SrN -/'h 4D SF,) 7K1 <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 kV <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 />