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0 <br /> Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> C <br /> Date: r I <br /> Landown mformation <br /> Name: e o n►,o— S-t'6 <br /> Address: 6 8 o r land_ eek_. City: 3e 1)e u Zip Code: W 535 eS <br /> Daytime phone: to 0 $- 2 Z `1 " ° 3 o r 6 0 8' - 8'3-2- E 8 o c) <br /> Fax: ,, , c- 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 U <br /> Property information: a's N it I k 104 <br /> Property address: <br /> Parcel ID#: ©`E VC3561 c 0 8000 — �-/ <br /> Legal description of property: o 0 <br /> E_ 1/4 of SC 1/4,Section ,Town of 1 't-t 1, <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No <br /> Additional information (optional): "Si o r �an <br /> Name of owner of original farm (if known): F d n e r <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 • Reg. of Deeds Doc. No. (if known) <br /> No • <br /> Don't know 0 <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 />