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.r_ P <br /> Dane County Department of Planning & DevelopmerF E C E J VED <br /> Application for Density Study Report <br /> APR 6 2016 <br /> 3/31/2016 <br /> Date: DANE COUNTY PLANNING&DEVELOPINENT <br /> Landowner information: <br /> Name: Susan B. Krebsbach. DVM <br /> Address: 1000 Wesley Road City:(lrcannn Zip Code: 5:1175-2ARR <br /> Daytime phone: 608-212-2897 <br /> Fax: F(1R-R35-51 R5 E-mail: DrSusan7a.gmail.com <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: �y <br /> Are you submitting this application as an authorized agent for the landowner? Yes 0 No® <br /> Property information: <br /> Property address: 1000 Wesley Road. Oregon. WI 53575-2686 <br /> Parcel ID#: 042/0509-152-9140-2 <br /> Legal description of property: <br /> SW 1/4 of NW 1/4, Section 15 , Town of Oregon <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 O Reg. of Deeds Doc. No. (if known) <br /> O <br /> No • <br /> Don't know O <br /> Comments: The density study is being requested to assess the possibility of a conversation <br /> subdivision on this property. <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 />