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lr c County Department Planning Development <br /> i_..-� - Dane County Department of & <br /> ',',,', p r;. Application for Density Study Report <br /> #`'co s Y <br /> Date: ,7j0 2 <br /> Landowner information: <br /> Name: O c S 1 g 1.(' 'C- <br /> Address: City: Zip Code: <br /> Daytime phone: 3„2C / 3 3'-/ <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: Rcj,/.-'71- Le.; -, C_ <br /> Address: l'7 - 0A A i,c D/' City: SYe,a5 4-72-1 Zip Code: 5 35-8-7 <br /> Daytime phone: ( 6 X . o /oc)o , i <br /> Fax: E-mail: kOb4/`f7`00,.5 Pi 7}�fii,J1/ <br /> Relationship to landowner: Pi,/rc A(),f✓ <br /> Are you submitting this application as an authorized agent for the landowner? Yes No <br /> Property information: <br /> Property address: <br /> Parcel ID #: Jc/ 1- /612--806/`S <br /> Legal description of property: <br /> 1/4 of 1/4, Section I , Town of '0Ak((1 <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes No ' <br /> Additional information (optional): <br /> Name of owner of original fann (if known): C/ <br /> Are there any recorded a -eements, 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 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 />