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.� , Dane County Department of Planning & Development <br /> ' .�1 4 ' Application for Density Study Report <br /> a <br /> . 4- <br /> Date: -O'4 - O ( '1 <br /> Landovyner,information: <br /> Name: ■0. y1 L . rn6 h-li'I <br /> Address: %ttO UNA C1nc �' City:1M, \\oreb Zip Code: 35 12- <br /> Daytime phone: o% ' 4?b- 1 y i <br /> Fax: E-mail: d c C-L.wv\ nit')c A I �VY1 <br /> Applicant;information (if different from landowner): <br /> Name: \J f\ <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? Yts_ _ No_ <br /> Property information: ((�� <br /> Property address: g%yO �p U.,�\y \`0 $ G <br /> Parcel ID#: 1 q O c ` � t CI -3 a© � �5 0 '2_ )�W0(:) k ) LVt\(0 <br /> Legal description of property: <br /> 1/4 of 1/4, Section% , Town of ?(-1.\ m rose_ <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): <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 /> -4 <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 />