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Dane County Department of Planning & Developm <br />Application for Density Study Report RECEIVED <br />Date: 47 02,Y <br />Name: ALJd)„ <br />Address <br />Daytime phone: <br />Fax: <br />Applicant <br />Name: 9 <br />Daytime <br />Fax: <br />APR 1 2020 <br />DANE COUNTY PLANNING & DEVELOPMENT <br />.e, City: Zip Code: <br />r -� <br />E -mail: <br />it from landowner): <br />re�CI- <br />City City4!�r777777 "✓7Zip Code��( °✓ Zip Code���` <br />E -mail: /��ccc�P�C� /ca iii Qll�rn <br />Relationship to landowner: <br />Are you submitting this application as an authorized agent for the landowner? Yes_a No <br />Property i <br />Property ad <br />Parcel ID #: <br />Legal description of property: <br />1/4 of )ZJ iC 1/4, Section �, Town of G' o - 'i <br />OR <br />Certified Survey Map ID: <br />Sketch map provided? Yes <br />Lot <br />Noll <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 th t ould affect the number or distribution of potential building sites on the property? <br />Yes f Reg. of Deeds Doc. No. (if known) <br />No <br />Don't know <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 />