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I <br /> , ,, ` ''� Dane County Department of Planning & Development <br /> ' _ / Application for Density Study Report <br /> Date:/ 2 g,?'9 <br /> Landowner information: �-Name:,'c'�Gz/ /'O ,i1 ,1.-U 7 A / - 1l7)�.f" /A/W l sc-�• <br /> Address: !• o' .. A , i awl sty:Cs/ ,z e Zip Code:Safi deor <br /> Daytime phone: G e2 - 7,r -,;;76,,s--6, <br /> Fax: E-mail: <br /> Applicants fo ation (if different from landowner): <br /> Name:i' e / ' -r,r,s/c/ <br /> Address: ' ,-, 4 -. _ City:/ .,,,cs-,/,4 C Zip Code: S ?J 2J' <br /> Daytime phone: a',J)"- a/a -2 <br /> Fax: E-mail: /N✓Q e4-s / G L ./ /:4/1.6 <br /> .er l <br /> Relationship to landowner: 46-e,.t, <br /> Are you submitting this application as an authorized agent for the landowner? Yes ® I1T' <br /> Property information: T �/ <br /> Property address: ,f9/2•Cc;z/4, �ty�i�/ -7' Cfe,s-s ,iv S <br /> Parcel ID#: Q a 0 /G'709- 6-(1 — SS a - O <br /> Legal description of property: a Sf 1/4 of) 1/4, Section ! ,Town of e s -S)-RECEIVED <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No DEC 4 2017 <br /> Additional information (optional): <br /> Name of owner of original farm(if known): DANE COUN7YPLiNNING&GEvEL.CP::vlr•• <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 O Reg. of Deeds Doc.No. (if known) <br /> No <br /> Don't know k <br /> Comments: .5, ,� c- <br /> 4/,i4/,, Sip ` G , ��lG riim, <br /> G/ J j 4 / i/ S l-1<�. n c� %. a-n Yr <br /> 10 /e�24'1^.- <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 />