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b <br /> Dane County Department of Planning & DevelopmeRECEIVED <br /> Application for Density Study Report <br /> sCCI�P� <br /> APR 1 1 2016 <br /> Date:6002//1,0 DANE COUNTY PLANNING&DEVELOPMENT <br /> Landowner information: <br /> Name: ►'h ave r D <br /> Address: Z2-3 5 Ca IAA o c‘4 City: m t Hoiz b Zip Code: 53572_ <br /> Daytime phone: (00Q, - '7?2- loboO <br /> Fax: (008 -aaa-Sag9 E-mail: m. rc ©msn. cow <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: IV one, <br /> Parcel ID#: b toblo -c9-14 3 - 8 00 l - (� <br /> Legal description of property: <br /> A/6 1/4 of ,Si iJ 1/4, Section 2 L/ , Town of 'Blue ue Jyl a v,v,OS <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No ® C OE TA�c. 4 Hoe 64) <br /> Additional information (optional): <br /> Name of owner of original farm(if known): j/eu/ <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 />