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4' Dane County Department of Planning & Development I J <br /> Application, for Density Study Report <br /> l S7-z3 <br /> )Eti(101 , -06°3° <br /> Date:SAP1b_ <br /> Landowner informatio // <br /> Name: Barbera ..1,I Qv� b Grass f l�+AS <br /> Address: 5141 t,&4 ()JIM City: Y Zip Code: C3528 <br /> Daytime phone: ( - ?la--2cr8$ v <br /> Fax: E-mail: b -bara P a t r A99.4- <br /> Applicant information (if different from landowner): <br /> Name:'So514,1.40 ,4�c cle-�2. / <br /> Address: (o(,3 t...j J ar 11 kit City: (,J; ke,r Zip Code: 5'3s98 <br /> Daytime phone: c,oe-3447 647 <br /> Fax: 0 4E- E-mail: •nrc,14:isue4e. ® piEtaj. co wz <br /> Relationship to landowner: Son- ;A- ig‘,43 <br /> Are you submitting this application as an authorized agent for the landowner? Yes X No <br /> Property information: I ( <br /> Property address: 6 '1 t Ep.ob►a,i.1-4 O a 1,(16 . <br /> Parcel ID #: �b04.n4 SQ�Z 103.'44 x'07 Ce n?733 gOC:03 <br /> Legal description of property: <br /> 1/4 of St 1/4, Section 23 , Town of 'rrvm <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): <br /> Are there any recorded agreements, liens, deed restrictions, easements or other legally binding <br /> c igr nts that would affect the number or distribution of potential building sites on the property? <br /> "*:4 v"5!nr< Reg. of Deeds Doc. No. (if known) <br /> No <br /> Don't know <br /> Mr <br /> Comments: SON <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 />