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A' Dane County Department of Planning & Development <br /> A a Application for Density Study Report <br /> Date: > l ay/aol 7 <br /> Landowner information: -� <br /> Name: �j pp,(,KR A J _ 14,, A '^N. <br /> Address: City:S-l-c,‘+,0- Zip Code: 5 3 5 $ I Daytime phone: J <br /> Fax: E-mail: <br /> Applicant (if c)i erent from landowner): <br /> Name: fZ iD L rJ t- v f�w . t S . l` c-p <br /> Address: k Q b City: (3 Zip Code: S3 Jr 99 <br /> Daytime phone: (.,o $- 5 j (4 - `) ei q <br /> Fax: E-mail: . • r, 1 . C. • ■ <br /> rv�. <br /> Relationship to landowner: So •.) <br /> Are you submitting this application as an authorized agent for the landowner? Yes ® No <br /> Property information: /� 11 ` G <br /> Property address: Cr T A -t��v c, LV, ) \., %, <3 i 1 <br /> Parcel ID#: . _ - • • • — . 51 o - - • - - ` OLD -3 <br /> Legal description of property: 1 <br /> tJ C- 1/4 of S W 1/4, Section I S ,Town of R��'0,I. k f\--4 D W �y W "¢ <br /> OR s 1/y o 0 nl 0 V <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): L L 0 4- .i. Pk-Q i3 RR A J A rV\ <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 O Reg. of Deeds Doc.No. (if known) <br /> No <br /> Don't know e) <br /> Comments: %f;a 2 1- S._.51.-S l vv...` k�z 4 O Act liD c v. th <br /> _ • . _ 2. r t. _ k - <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 />