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Dane County Department of Planning & Development <br /> V r Application for Density Study Report <br /> CO14S <br /> Date: 6//6//(0 <br /> Landowner information: <br /> Name: — <br /> Address: if ir/ Wi'/10f h - fl r„ City: Zip Code: 3/.JS�,fr <br /> Daytime phone: �Jl <br /> Fax: E-mail: — <br /> Applicant information (if different from landowner): <br /> Name: 6rec, Rice ` /le,1 Isti.14 13roker <br /> Address: /Qo1, 'Si: (A� are City: 5f o w S klo- Zip Code: ,'3.�'d' <br /> Daytime phone: 60'4.- 7'1 0 - 33 3 `I <br /> Fax: 1 04-`,Zc/2, /211 E-mail: Grp O l/s'�l- �'1G/i7. �ow- <br /> RRelationship to landowner: Ae (proof/ �) c'ur .t�.1/1 74 M i 1'f;�- od.e r <br /> Are you submitting this application as an authorized agent for the landowner? Yes No.4j <br /> Property information: <br /> Property address: jä / (,) //,'6,r►,i Dr. <br /> Parcel ID#: J/ji//b - %ek/..s/ <br /> Legal description of property: <br /> 1/4 of 1/4, Section , Town of ,pliedu,'1 ,'e1yJ <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): I it(J8 m A 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 Ai <br /> Com ments:: j (,)0wl (/1, d itni d- <br /> o pv tl Jt 0-46'1J (*co[,/ -1!J 14if rc,1 IroJ -l/1I A ^ <br /> (/ bLA) )0 c. <br /> u.sl o r., i'- rt kb-641,1",,,s i 6 0 acre./ w).4 L t�c L C.Li off c Jk' <br /> nr, <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 />