Laserfiche WebLink
Dane County Department of Planning & Development <br />Application for Determination of Parcel Status <br />Receipt # <br />Landowner information: <br />Name: ,."(t FL) Q:f/7 <br />Address: 3 �O S� 1 _.�.: /��, ' j City: ,/l,. Zip Code: <br />Daytime phone: 23 f- 27P3S- <br />Fax: /tio� <br />E-mail: <br />Applicant information (if different from landowner): <br />Name: <br />Address: City: Zip Code: <br />Daytime phone: <br />Fax: <br />Relationship to landowner: <br />Are you submitting this application as an authorized agent for the landowner? Yes No <br />E-mail: <br />Property information (be as sp� jci is as po ible): <br />Property address: yg L f� �ofyck � d �p� G %/- �357V <br />S <br />Tax Parcel ID#: QS/ ? --/y/ YD 6 <br />Legal description of property: <br />1/4 of 1/4, Section , Town of OR <br />Lot(s) , Block , Plat of <br />Sketch map provided? Yes No <br />Additional information (optional): <br />Name(s) of previous owner(s) (if known): <br />(Jolt /216:-/- <br />Compents: � � � f fp � Sc� ea., G /(4 >>�/‘/�o J�o �, � / � r ��� <br />/ <br />®r c.✓ C-F / s to / I czA ( M Lc / <br />Important Notice: A Dane County parcel status determination is preliminary in nature and <br />only determines if a parcel of land was created in accordance with Dane County ordinance <br />provisions. Additional title history research conducted by a title company may be necessary to <br />verify parcel status. Dane County and its staff are not responsible for any misrepresentation or <br />mischaracterization of the information contained in the parcel status determination. <br />Please allow 1-3 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 />http://dcinet/uploads/imservicerequest/scwl /Parcel_status_application.doc <br />Page 2 of 2 Revision 1.20.2010 <br />