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rX Ud LL'/ 11111L <br />JLr-uu-LUU7ilLC) ID:JC <br />f - uul <br />Date: Ddo,6c,?5,,',2C07 <br />Dane County Department of Planning & Development <br />Application for Determination of Parcel Status N0v 30 20�9 <br />o��E <br />IN o\,AcaN1�r & a�40°t��ENi <br />Receipt #co' <br />Landowner information: <br />Name: <br />Address: 3�'s 1( /1/. E'N'41/ City: 6///C`,4G-O Zip Code:. 1006/J <br />Daytime phone: D 22Y- e •- 5- <br />Fax: 6 34 Sl S - S/? 51 E-mail: /2e l/ce / 1 �i�✓o . rain <br />Applicant information (if different from landowner): J <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 No <br />Property information (be as specific as possible): <br />Property address: 3,1- <br />Tax Parcel ID #: O S /,2 : 30 5 - S <br />Legal description of property: <br />1/4 of 1/4, Section , Town of OR <br />Lot(s) 8 t/1/yFT, Block 2 , Plat of 0,5-51.300 <br />LOT7 <br />Sketch map provided? Yes / No "Cc 025 7 OS / /-2 C <br />Additional information (optional): ` 287 <br />Name(s) of previous owner(s) (if known): <br />Comments: <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 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 />S \Web_Transfers\PlanDev\Paul status application.doc Page 2 of 2 Revision 11.26.2007 <br />