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• <br /> asoYei,' 6..1... ..'„0. <br /> 6.,..,,,t, rv... <br /> RECEIVED <br /> ,{ = Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> 4t <br /> .1 . MAR 1 8 2016 <br /> DANE COUNTY PLANNING&DEVELOPMENT <br /> Date: 3-/g-2.4b, <br /> ' <br /> Londoner�information: <br /> Name: „el/,;t _.4-1{� ti .05dtp,., /.=� uST ) <br /> Address: ' C' y:Aga.; Zip Code: _s-3 71 <br /> Daytime phone: geA - 2k,--3.-75 <br /> Fax: E-mail: 4,44,47-, e65i=�.(2, Ga..06 S ,Q/rEi+mss,1,44,.k, tam <br /> Applicant ip tion'(if different from landowner): <br /> Name: � �r(2.- 5 <br /> Address: 273t< FY) tot * City: L i9A./ks Zip Code: 5352g <br /> Daytime phone: '-2/5 -tux) <br /> 7 <br /> Fax: -/7$-lieo E-mail: e./41,42 A �i/,,,--4-��.t'ayst <br /> Relationship to landowner: /do AU , <br /> Are you submitting this application as an authorized agent for the landowner? es • o 0 <br /> Property information: / <br /> Property address: g7/1 h ,=CAA- - 5 boil- k s ILA .5354 <br /> Parcel ID#: ab - 01. 04' - ' _ d <br /> Legal descriptiqn of property: <br /> 'ti 1/4 of N G) 1/4, Section 10 , Town of G i*.' p/„_.„.._, <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? es No 0 <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 /> on't know 0 <br /> Comments: ■ La fik- 1f f[�41 l✓' . s. I. &� • - m�� t M, <br /> ' • iJli1 - f •7 t7- •z --`Al,- <br /> A- 1c . 001 3"01 /e PA ' - , <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 />