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PC- P-P E / -20( 6 - 0003 " <br /> . i {, <br /> Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> • AP" 9 <br /> 8 --c' <br /> 8/09/2016 <br /> Date: <br /> Landowner information: <br /> Name: Luke D Forseth, Stephanie N Forseth <br /> Address: 1654 Serino Rose Rd City:Verona Zip Code: 53593 <br /> Daytime phone: ( ©, ' - / t <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: Sarah Aken <br /> Address: 7191 County Road PD City:Verona Zip Code:53593 <br /> Daytime phone: (262) 719-1260 <br /> Fax: E-mail: spasch85 u amail.com <br /> Relationship to landowner: potential buyer of property <br /> Are you submitting this application as an authorized agent for the landowner? Yes 0 No • <br /> Property information: <br /> Property address: no parcel address available <br /> Parcel ID#: 048/0507-011-8680-0 <br /> Legal description of property: <br /> 1/4 of 1/4, Section , Town of <br /> OR <br /> Certified Survey Map ID: Lot LOT-2 CSM 15162-3- CS gy17-) by-23-11 <br /> p-jSC2 fts SEc Ot-ns -a- CY(13,5i° NW ►J4 <br /> Sketch map provided? Yes 0 No 0 NE (I P NC'1 1f q ee J <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 S Reg. of Deeds Doc.No. (if known) <br /> No A"� <br /> Don't know 0 ok <br /> totitul <br /> Comments: cti r V ,"k to RA-en-hag A p' ✓-�-y 14:54.ear a b nr( , "Ls <br /> ciA le <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 />