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Dane County Department of Planning & Development <br />Application for Determination of Parcel Status <br />COS' <br />Date: £kc- <br />andowner i_n�fo�a.Ct .n <br />Name: �_ V <br />Address: `i 2 �() ,t. /✓ City: t 't Zip Code: C I. <br />Daytime phone: <br />Fax: <br />E-mail: <br />Applicant,informatio (if different from landowner): <br />Name: �`ee 3 a" h 5 d'' ia►' = r c . <br />Address: TD G VC- lit t I,.S gar City: iolliviesfrN Zip Code: 5,5 6 $g <br />Daytime phone: tort$ 5 7lc- <br />Fax: E-mail: G r c-cti, �{ �.5 E. i S 2 Gl �3 C . Co`"-1 <br />Relationship to landowner: // 4 <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: (- Gj I <br />Tax Parcel ID #: 0 �� <br />1_,g.41 description of property: I <br />Alt 1/4 of 5W 1/4, Section 1.. (p , Town of f� , b I OR <br />Lot(s) , Block V , Plat of <br />Sketch map provided? Yes /`- No <br />Additional information (optional): <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:\PlanDev\Zoning\ZLR\Forms, Applications & Informational Materials\Parcel status application.doc <br />