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Dane County Department of Planning & Development <br />Application for Determination of Parcel Status <br />Date: / 7 -- 57 <br />Landowner information: <br />Name: SD Off' / 5 <br />Address: <br />Daytime phone: <br />Fax: <br />Z1 <br />i� <br />City:'��r/o%i Zip Code: ��a5"f <br />E-mail: 112, <br />s115,> ' c®J ,/ <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 informatio be3 spec! <br />Property address:. C C�PE' <br />Tax Parcel ID #: V5 l; ._,�S z —a / - 5 <br />Legal description of property: /J / <br />1/4 of att./att./1/4, Section R5_ ,7/ , Town of �'�'4/off% OR <br />�✓ lr� > CD*.S S :?/ <br />Lot(s) , Block , Plat of <br />Sketch map provided? Yes r No <br />Additional information (optional): <br />Name(s) of previous owner(s) (if known): ea / i /v/ 6-; 444 <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 />