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1X-P-ptN-ID r -000 33 <br /> Dane County Department of Planning & Development <br /> l�'� .' Application for Density Study Report <br /> Date: WC/4 <br /> Landowner information: <br /> Name: 6ary E/17w-, Fanw;S <br /> Address: 'Pa" 4 ,N, 1444 - Q City: era°,-/yrl Zip Code: S'JS / <br /> Daytime phone: G op - dP 4,3- 24/7 <br /> Fax: E-mail: <br /> Applicant information (if different from landowner): <br /> Name: Dan Fr f'n/ r�.,td,S <br /> Address: 6,/2736 Fw,clt, IN City: aci/e.:4 Zip Code: £ S P <br /> Daytime phone: Cop- ee-13- ay/J <br /> Fax: E-mail: G owx.O,S c6J'o e 4 <br /> Relationship to landowner: p6,ren1S <br /> Are you submitting this application as an authorized agent for the landowner? Yes 0 No <br /> Property information: /� '1 <br /> Property address: /S. C 41 �%9hl�. U�erza hr �.� ncd <br /> Parcel ID#: 61/2 Sol - 142-g00°, 3 <br /> Legal description of property: <br /> 1/4 of 1/4, Section , Town of Or-ecd,dn <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 <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 /> I <br />