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kECEr d Dane County Department of Planning & Developme t IVED <br /> Application for Density Study Report <br /> APR 4 2016 <br /> Date: a e i► )080 DANE COUNTY PLANNING&DEVE1ppM <br /> Landowner information: <br /> Name: 1-1 D to a, -r .10 -115 , I y, t✓ p <br /> Address: //6-0 /-1 City: Ca " 106 c c,Zip Code: 6 3 o 3 <br /> Daytime phone: (o o - 3 - v if <br /> Fax: / /A E-mail: / e rt fa Yrn a e h et tax [d <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 0 <br /> Property information: J! <br /> Property address: 4f (o <br /> Cigar V� e Lv' 1Z d// <br /> , C:9 11/ b r-, V// <br /> Parcel ID #: O (e J - l -I 3 ` 8 710 - 4 <br /> Legal description of property: <br /> iv 1/4 of c iv 1/4, Section / y , Town of C I S *s a n <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No Q <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 /> Don't know <br /> Comments: ► i s hrx,dt, `t- AA` I % kg <br /> -4-Atekcedd p.A.,4-7-9 6 t. $2,i cte <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 />