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���; \_ RECEIVED <br /> 1.7-1 Dane County Department of Planning & Development <br /> •-_ ." Application for Density Study Report <br /> le s JUN 1 4 2016 <br /> DANE COUNTY PLANNING&DEVELOPMENT <br /> Date: 6/H /16 <br /> Landowner information: <br /> Name: a-5771 re" a r e L e:1 4 N o t K I D& c t i , r.J ( f) c a-yo—D, <br /> Address: at 7 y Ye H x.16 i 0 ux b4. City: 0 rtzto a Zip Code: S.r's 1 S <br /> Daytime phone: <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: MANg, g ► c- E <br /> Address: ,2 7P5 TKO ✓c,,,,,✓ Akv be. io City: -F.TCNSir Zip Code: SY'71/ <br /> Daytime phone: Gcnv- a-?s,S-vs7 <br /> Fax: E-mail: e,eccw,@ F KSr / e5 t . Ca <br /> Relationship to landowner: ✓q G c <br /> Are you submitting this application as an authorized agent for the landowner? Yes 0 No 0 <br /> Property information: <br /> Property address: L( 7 a i( Sc tir!e ifl e D,r. p g--CC<,4 wT se's 7J <br /> Parcel ID#: oGio _ i93 - 900/ - 6 <br /> Legal description of property: <br /> - -tni 1/4 of 5 v,) 1/4, Section /7 , Town of ` (0 t'N"/ <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No 0 <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: <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 />