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06/13/2008 11:30 608-267-1540 DANE CO PLANNING PAGE 02/02 Dane County Department of Planning & Development Application for Determination of Parcel Status Date: t, f 4_108 Receipt Landowner information: Name: Address: City: Zip Code: Daytime phone: Fax: E-mail: Applicant information (if different from landowner): Name: 9-41 11 (►JrccofZ G¢.oup C 1Z tGR- 2— Su IJA-5� Address: 1A#i,J r �aJ City:.Zip Code: 53 Daytime phone: (also 988— Sow Fax: LI z.o) (14 .— 2v84 E-mail : eA 12,'Sc0.L-ita µ e * . C-01,1A Relationship to landowner: pt Are you submitting this application as an authorized agent for the landowner? Yes X No_ Property information (be as specific as possible): Property address: 2-i 7'3 id • Dta 4 V'-/' 4 Tax Parcel TD #: Legal description of property: 1/4 of 1/4, Section , Town of OR Lot(s) , Block . Plat of Sketch map provided? Yes No Additional information (optional): Name(s) of -previous owner(s) (if known): Comments: Important Notice: A Dane County parcel status determination is preliminary in nature and only determines if a parcel of land was created in accordance with Dane County ordinance provisions. Additional title history research conducted by a title company may be necessary to verify parcel status. Dane County and its staff arc not responsible for any misrepresentation or lonlarac te rizatfo n ofTReh itniiiJrive &ma :,..-d'iwt?leCp*l*'*Meek 11.WR Please allow 3-6 weeks to process your request. A copy of the report will be mailed to the landowner, the applicant (if different from the landowner) and the town clerk_ S:\Web Transfers\PlanDev\Parcel status application.doc Page 2 of 2 Revision 11,26,2007