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Dane County Department o f Planning Development <br /> • <br /> Applica 0.15408 $i l 9P9rt;:r <br /> { <br /> Date: kG--Z - ) <br /> • <br /> Landowner information: <br /> Name: M/1-rateW FoRD <br /> Address: -7(ago ((,-Ca,t roorL gmcd. City:- 'I/Conic, Zip Code: 53 S-91 <br /> Daytime phone: 6a-- to -2.7-o y <br /> Fax: E-mail: MJFriAp 1 s Grnai f_cvnn. <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 0 <br /> Property information: <br /> Property address: /3-r.I/off Iva- 644A-1 Lv 535—I S <br /> Parcel ID#: Dl176-1S2 - o-3,#alb(,--15,_- s&7--o <br /> goJ -a 2-qo o-y_` o7ob'is1-9510x-•v,¢o7v4-u a-qc'o-7 <br /> 6C) -I 0— S <br /> Fc,-}l3 <br /> Legal description of roperty: 3 0, o 0 0 <br /> 1/4 of 1/4, Section ,Town of <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): J,) Jati pcw. Oil. •/ru S f <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: i k . - ,- �, -to or of t1`orwwn t a ram, s for • <br /> 460•41-1- f hi ' S-1'wii,IcL k 1-;,r d lwou s-s - i.( ivILS ho4ui-o.btf, <br /> on 0-04wur ho ' hrcf.1 aarti y4#tr /Di pru/inrjstvJ. <br /> 1 0 <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 />