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7CPDC N <br /> 20(x— 0000 (0 <br /> v' Dane County Department of Planning & Development <br /> ,4 e Application for Density Study Report <br /> sus <br /> Date: �l 7 <br /> Landowner information: <br /> Name: , ,hc r\ CA-nil, CS <br /> Address: i . .. City:rY)t. Nor e b Zip Code: S 5 7 <br /> Daytime phone: (DOS 1, - 4 47 <br /> Fax: E-mail: ConnorS•rno �, ma,� .cprn <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 0 <br /> Property information:_ R�, <br /> Property address: 3'-15() C urn <br /> Parcel ID#: (J11 D`7 - 341 - Do`� 1 <br /> Legal description of property: <br /> 1/4 of 1/4,Section ,°Town of C,rn sS P)Q,n 5 <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No O <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 0 <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 />