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,`' Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> Date: 5.-‘) I --/ g <br /> Landowner info mation: • <br /> Name: IL/ .� (/5i11,, <br /> Address: 763,:z C7Y HvP A City: 5g//E vi /,0- Zip Code: 53.?0d' <br /> Daytime phone: („(It C77 - 1,-2.2 <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 ID No 0 <br /> Property information: <br /> Property address: 7630? C T Y fri w PA l3a "/e Vi I e. tiv.I. 53.3"0 8 <br /> Parcel ID#: C rid '90'40 O <br /> Legal description of property: <br /> 5W 1/4 of NL.) 1/4, Section 1 , Town of MD <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 ° Reg. of Deeds Doc. No. (if known) f�F �1v <br /> No _� ED <br /> Don't know 0 <br /> Comments: NAY 2 5 2 <br /> DANE Quay <br /> PLANNING&DevaopmENT <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 />