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Cis <br /> i _ Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> '3CCotiss <br /> Date: 5-I - I <br /> Landowner information: <br /> Name: 0'ac1e.11 'Ftjv IrDevocnbtt Tc�S* <br /> Address: SO9 GIma01 A City: $r•ooKlIn Zip Code: S3511 <br /> Daytime phone: <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: Clilasg & r-;p,11 0-CoSk-ee' <br /> Address: 2589 Lco f.ta !Alm( 't3 City: Svn �'ra�c,e. Zip Code: 5359 0 <br /> Daytime phone: 60g- 267-870 c) <br /> Fax: E-mail: chaser 5$87111.9Ma'a,cow.. <br /> Relationship to landowner: 'Try s+ee i n O`get tn Farm k/ S r.cevocable. Trust <br /> Are you submitting this application as an authorized agent for the landowner? Yes No X <br /> Property information: <br /> Property address: <br /> Parcel ID#: OSO9-211-8220-3 0509-211-$120-8 OSO3-271-'loco-7 <br /> OSo9-2-/ I-8610- 0509-2'12-8030-2- OS09-2:72-9502-9 <br /> Legal description of property: (see q-4-ktc.le‘ed) <br /> 1/4 of 1/4, Section , Town of <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes No <br /> Additional information (optional): <br /> Name of owner of original farm (if known): j?a I p ti + M a+-9 a ce,'l' 0 c.l3r■e I► <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 <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 />