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Dane County Department of Planning & Development Application for Determination of Parcel Status Date: i ► 1 / G l U-7 Landowner information: Name: ?f7ZRy AND LUZ 1 ,H- UC.. 1 Address: 6C) i CT H'w A City:liZip Code: Daytime hone: U 8) 69 k— , 4 e Fax: ( boa ) g•3 S . 8.dr.gf E-mail: s35-Z/ (I&oQ r►yt•N) Applicant infprmation (if different from landowner): Name: pJArqC Ysl I NTf Z Address: 4 O 5. ►�ZCity: ,l%1•,�)j\rJ Zip Code: s?7) c) Daytime phone: � Co ce) S-2 G - G i ► 3 Fax: $2 I • 82.u► E-mail:/C7vg A/W)Nrcize ►nl ►n/7-4RLAr.I •NEl— Relationship to landowner: 13Liye TZ V n17) fZ. ff N?)) n16 or rsz -rL fii /1C H -4S t Are you submitting this application as an authorized agent for the landowner? Yes X No Property information (be as specific as possible): Property address: ( O) 6 C fiy I-) w y A Tax ParcelID#: 0509 — 207 — SU0—% Legal description of property: N Vsl 1/4 of 1\J14 1/4, Section 2 0, Town of Or e juel OR Lot(s) , Block , Plat of Sketch map provided? Yes No Additional information (optional): Name(s) of previous owner(s) (if known): Comments: C / r eJI i c, �• Her r i1 Th y, i i tniC:,l r r a." 4 y r- cO Doc NO 39357 3y- / 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 are not responsible for any misrepresentation or mischaracterization of the information contained in the parcel status determination. 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:\PlanDev\Zoning\ZLR\Forms, Applications & Informational Materials\Parcel status application.doc