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k�� <br /> o '� ttt Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> Date: /0_361_0 <br /> Landowner C +information: J/ <br /> Name: e4e ,t . A L.a of <br /> Address: 376.6,/„/eo t A4 City: / , bore 6 Zip Code: 3-3.5-7,2 <br /> Daytime phone: 60?-798-3 Y 75-” <br /> Fax: -- E-mail: — <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 ID No <br /> Property information: b / hid / <br /> Property address: 37?5 Gar�.ar , �t. /'e F3 t 55572 <br /> Parcel ID#: <br /> Legal description of property: .5" <br /> ,S 1/4 of S4. 1/4, Section /q , Town of I-r6SS aaInS <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): <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 ®' <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 />