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• , <br /> 44Vil pAio <br /> C.A-f <br /> Dane County Department of Planning & Development <br /> ; Application for Density Study Report <br /> eatireASV <br /> O <br /> Date: C. � <br /> Landowner--i formation: <br /> Name: p 11 !. �,-,G1 Yl 2 <br /> Address: c � ` rot City: Q reg.-711 Zip Code:`-r 3s''7c <br /> Daytime phone: 3 <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 No <br /> Property information: <br /> Property address: <br /> Parcel ID #: 0 501 2 ; 2 10 0 0 `f <br /> Legal description of property: <br /> 1/4 of 1/4, Section , Town of <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 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 <br /> Comments: cO At, �L t 0 + 0 A .i C'ItV ..t_ <br /> ji) (cA.t.T.-) . <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 />