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o <br /> Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> 44006 <br /> Date: 3I w h'1 <br /> Landowner information: <br /> Name: To C Frc vn e <br /> Address: t}i-F 19 co,n-} r Cityf µo%/w\AS. Zip Code: 535 7 <br /> Daytime phone: (oog--7y-7 .�3 4.1) <br /> Fax: E-mail: <br /> Applicant ipformation (if different from landowner): <br /> Name: Ve 1 Ni ‘I On. 2"1 <br /> Address: 0 3oX 3 4 g- City: , adz_ Ea Zip Code: $3 s �S <br /> Daytime phone: 10 0$'-I tO 1 - l S O S <br /> Fax: E-mail: 160.-tl e yrt;1 t ort'Lt 14w�,•r . C 0 ,1 <br /> Relationship to landowner: cc - -- . <br /> Are you submitting this application as an authorized agent for the landowner? Yes !r.' No0 <br /> Property information: _ <br /> Property address: Ca�r�4�c (leads V <br /> Parcel ID#: Sc.e o kc* -' ec( L\ pacce`5 <br /> Legal description of property: <br /> 1/4 of _ 1/4, Section ,Town of /e.c . <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 CV <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 /> REV 01/01/2019 <br />