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Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> Llwr- <br /> 40 <br /> Date: V/7 <br /> Landowner information: p wow /2( <br /> Name: '44;I/ ;Q -j4 C. C u km pf.A %n <br /> Address: 6Mo Su+& Uir f7 y Pkc� ity: 7'(,),� Q., d„rZip Code: S.-1 -7.f <br /> Daytime phone: bay Y� �o.S-8 Y <br /> Fax: E-mail: G/;//CC@ rktezn71- wt <br /> Applicant information (if different from landowner): / 1�L '� <br /> Name: CR+0 of CIS WQ // <br /> Address: City: Zip Code: <br /> Daytime phone: <br /> Fax: E-mail: <br /> J�( <br /> ,3 <br /> Relationship to landowner: <br /> 0 v( 1 <br /> Are you submitting this application as an authorized agent for the landowner? Yes 0 No • fa <br /> Property information: I/ J <br /> Property address: G 06'o s�n !/a 6l ey ?A etiy, &9 60).z. (d-r SJs7'"� <br /> Parcel ID#: 0 g-ogOS38' roo8 aKd O OS34000t <br /> Legal description of property: <br /> 1/4 of 1/4, Section , Town of ©r-e7on <br /> OR / <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No C <br /> Additional information (optional): � D CC/ / / d/ <br /> Name of owner of original farm (if known): CT i yt q�LGT �2 <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 ft <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 />