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U} ,► Dane County Department of Planning & Development <br /> oftV Application for Density Study Report <br /> xfuf <br /> e <br /> Date: 2,-1x-2,61(1 <br /> Landowner information: <br /> Name: J,.cc -f&' ar 4 / 1 gIMrel Farms 4. land LL <br /> Address: 31.119 1:464. LaAt. City: (. /,o r)4. Zip Code: S3.S73 <br /> Daytime phone: (06R- y 39- 3 0 6 7 - <br /> Fax: E-mail: J e rcx,„ „Di ter,4,1•co"-, <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 • <br /> Property information: LAS <br /> Property address: C O r a`� <br /> Parcel ID#:5 01707 36 y 90005 AND 0707369 9'S0Ob <br /> Legal description of property: <br /> 1/4 of 1/4, Section , Town of <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 0 0 <br /> Don't know • <br /> Comments: C4 >> ar t •n ct:) w= 9ytS �onS 7.7)on k <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 />