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r � <br /> • <br /> Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> Date: 74/_437) <br /> Landowner information: / J) f y� <br /> Name:joy( c,4/'1if f[� /Io /7t�d)r ^ /` ,t ic/�t`j/'e /e..e, l,'. <br /> Address: es . S .,sr'/, ea/dr. ity: /,f,.f Wt,Zip Code: <br /> Daytime phone: .4'f).'C) U/a c <br /> Fax: E-mail: <br /> Applicant inform•tion (if different from landowner): <br /> Name: �� - t <br /> Address: A City: , j"<,t Zip Code: ,S�s� <br /> Daytime phone: - eQ'G� / <br /> Fax: E-mail: /7�jesecyj'CGS/A 7<(/////x1 1`cJCc^'1 <br /> Relationship to landowner: ,A6. it./ <br /> Are you submitting this application as an authorized agent for the landowner? Yes V No <br /> Property information: <br /> Property address: ---z9'709 - %L e,, 'O-a 0709-0 <br /> Parcel ID#: (/O 7- G yy -G • l 37 2 9 -G Y% Ssa/ <br /> Legal description of property: ,p <br /> NA,/ 1/4 of,SI' 1/4, Section 9 , Town of'Pass <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):4/07/1/(/' - c 6?)44e SLR`t/'Q✓� /r <br /> /1"'t. <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 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 />