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r . <br /> Dane County Department of Planning & Development <br /> Application for Density Study Report <br /> Date: 4-/ag-faolvl <br /> Landowner information: <br /> Name: 5+evec\ f) Sntih <br /> Address: w 1,44 3 Rczl^ey ➢r, City: L.. Zip Code: 55555 <br /> Daytime phone: Got- 4-7 7-DO q 7 <br /> Fax: E-mail: S wS M h 3e u w A l,M"_ , . <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 • <br /> Property information: <br /> Property address: <br /> Parcel ID#: 0706 -a63 - Mood - 6' ; 0717G - ;63 - S`lto - 0 r 0706 - a63 -tS7,7o_0 <br /> Legal description of property: <br /> w 1/4 of sW 1/4, Section as-7 Town of Ve CA 1't <br /> OR <br /> Certified Survey Map ID: Lot <br /> Sketch map provided? Yes 0 No ® <br /> Additional information (optional): <br /> Name of owner of original farm (if known): 3 le u ON N C ' S i .r+ ?e r o�C <br /> Gore S1e021`C. <br /> Are there any recorded agreements, liens, deed restrictions, easements or other legally binding <br /> St" <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 <br /> Comments: There i5 GI` easement lc, f dr'i\t" T, r,,P^ <br /> Gutsi e c- f' %I <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 />