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0 <br /> Dane County Department of Planning & Development <br /> A,0 Application for Density Study Report <br /> eti"gi dL+cel <br /> Date: w 1 - i$ <br /> Landowner information: <br /> Name: O S GM ! \ S O R x <br /> o —1Z1) 7 <br /> Address: 5511 l ,rcpv. 9c) City: Rcnop() Zip Code:533&I <br /> Daytime phone: (p 0 - ? 3 - 15 0a <br /> Fax: E-mail: L ET I K Le: S O C (o/Y\A-IL i tom <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 e <br /> Property idress: 5�1 t gRct � R�C,1.. t� , 535a 1 <br /> Property address: <br /> Parcel ID#: O50133 t rgo00 O5Oq ?s31Q ca4 o ng <br /> ()soot go 5O0 <br /> Legal description of property: <br /> ')& 1/4 of NE- 1/4, Section 3 3 ,Town of 0 Non r-\ <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes Of 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 •0 <br /> Comments: WIZ_ k.vpk,3 1 Wt. CLIn Q6- \ u-r <br /> a b�;kd-a11jiy ��A , \ Cor-cert4A/ 1��Vr Le I Atas <br /> 0,■0 d • NeQck k io w4tn nL o u.\c i s <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 />