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Dane County Department of Planning & Development RECEIVED <br /> Application for Density Study Report <br /> deor JUN 1 4 2016 <br /> Date: lo- 1 DANE COUNTY PLANNING&DEVELOPMENT <br /> 10 - b DANE <br /> Landowner information: r 1 <br /> Name: 'SL\'t e_ c r-4-OoA <br /> Address: 11 O lS \� h St • City ko &c s Zip Code: <br /> Daytime phone: WS t"- 4%1-31 tc <br /> Fax: E-mail: '\gci -cook o�i k c .met. <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: C(13S P{Y h∎A r La Re f INl . *\oc eb � 5351 <br /> Parcel ID#: 0(00(0- tt a-q S 1O -�1 Ste ci-c-E-aC.he -Far 1isk■ of czls. <br /> a��S e6s ,� L C�� \ - 1a3s ,°c k t - Lan-� <br /> Legal description of property: <br /> 1/4 of 1/4, Section ,Town of ' t NCO t i\c <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 f a r m(if known): A Y-41i. t r -'r to< cte_ e Co ff, <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 O <br /> Comments: ' (kY M V3(3 C\ \ Cls eg$2)\ r&Ankkin <br /> \.\ot,-Aa VOCAL At --C,OLZ \o,>J c-\ its) h «; s�- c �OulL\ <br /> \ otv a\ct1� a �ro p-�ai - �rn ( po,ecQ . <br /> f ctp Cs ' c Ro s c..ck 62s cc∎ nS <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 /> V2.'2-QI ea(XOSe . <br />