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Dane County Department of Planning & Dev <br /> Application for Density Study Repo L, IVED <br /> 1Ba9; . <br /> -'0co1 <br /> AUG 192016 <br /> Date:E— ( g - / lQ DANE COUNTY PLANNING&DEVELOPMENT <br /> LandowRer information: <br /> Name: 1'c�-f- 1�J 5 Se-i f <br /> Address: 11'lS lRlndt� Ind. City: peer.Ige /d. Zip Code: S3 3 <br /> Daytime phone: ( 8- 6 g p-16 3 <br /> Fax: E-mail: <br /> Applicapt inform tion (if different from landowner): <br /> Name: rre CL t 05 SE-1/ <br /> Address: 11 '15 R c n d e .� �1'c( City: Oe�e f-F',e. I� Zip Code: 3353 1 <br /> Daytime phone: 6b$-- t„. .-Z`f 97 <br /> Fax: E-mail: <br /> Relationship to landowner: 3 O v` <br /> Are you submitting this application as an authorized agent for the landowner? Yes No! <br /> Property information: <br /> Property address: IV(,4 <br /> Parcel ID #: 011I - /52 — g000 — 'oZ <br /> Legal description of property: <br /> S W 1/4 of 14 W 1/4, Section/C-7-11, Town of C o f G p 6 '-c✓e_ <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 ^Q9 <br /> Comments: U , Avg/ la 6 1 e ' <br /> J\ <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 />