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Dane County Department of Planning & Development <br /> jot . <br /> Application for Density Study Report <br /> �1MS; � <br /> t�l; <br /> 3c RECEIVED <br /> Date: f2b'"- /7 <br /> MAR 2 2017 <br /> Landowner information: pANECOUMYp�ptyN�NG&DE�LOPMENT <br /> Name: DO ha �� P .Sc 4 ( (er <br /> Address: `� '7 SC�, ��F h �j� City: V k if° IV( Zip Code: S9 <br /> Daytime phone: C - 2 1 I /557 <br /> Fax: E-mail: <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 information: <br /> Property address: /le) iDarLe/l �1/cidres5 <br /> Parcel ID#: 07o 6-68--O'4 F-S"O — 1 <br /> Legal description of property: <br /> W 1/4 of 55 1/4, Section45-3, Town of 144.0144Y-D-5 <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 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 0 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 />