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`/ c.pbeN -tot -oco <br /> Dane County Department of Planning & Development <br /> Vcfrigiao Application for Density Study Report <br /> esbuoe <br /> Date: ( Sp 1/7 <br /> Landowner information: <br /> Name: R iChlr32 f <br /> Address: 677- S TC'SZ�To t�..^ City: 3,?..d K y ice( Zip Code: c352- ( <br /> 2 <br /> Daytime phone: 60 '331/ cr 9'w/�3 <br /> Fax: E-mail: $'t/C-(02 pR14iRtC Aar 14-714 L.00�- <br /> Applicant information (if different from landowner): <br /> Name: <br /> Address: City: Zip Code: <br /> Daytime phone: <br /> Fax: E-mail: <br /> Relationship to landowner: <br /> Are you submitting this application as an authorized agent for the landowner? Yes 0 No •O <br /> Property information: ,' 9 3 <br /> Property address: 8(7 5 STOR TOc ! �17 K��( W-� -� ( <br /> Parcel ID#: (')cr) ( - (' - 7000 - by <br /> Legal description of property: Q <br /> CO 1/4 of cC.t ) 1/4, Section (7 , Town of 2 04 <br /> OR <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): I N �- (`05 <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 /> Reg. of Deeds Doc. No. (if known) <br /> No <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 />