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Date: <br />Dane County Department of Planning & Developmerr, „,, <br />Application for Determination of Parcel Status :"ice.:.''- <br />3 - O <br />Landowner information: n(� <br />Name: Frec1, riLk ,t- Vir9;n;c. l�eu+-Ji;n <br />Address: 101 j q /'Y)a k e w scn IQ d • City: ✓Y%4 zo rna n Zip Code: 53 <br />Receipt Pt <br />MAR - 4 2009 <br />Daytime phone: CD k- 7 ci 5- O o 6 0 <br />Fax: E-mail: Fredv r9;,,:a (DJ mU:I.c647► <br />Applicant information (if different from landowner): <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: 10Iact l lathewSnot Rck. Pia zn,4,an;e 1;O1 53s(o0 <br />StuA y a II PQI'dels. <br />Tax Parcel ID#: 0g-033-9030-q i 0$D(4,-101-85Oo-9 ) 0306-/01•9000-42. <br />0706 - Loa.-VSoo- S , OV06- /03-g060-07 , 0306-1o0-gsyo-. <br />Legal description of property: <br />1/4 of 1/4, Section , Town of OR <br />Lot(s) , Block , Plat of <br />Sketch map provided? Yes No <br />Addition~! 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:\Web_Transfers\PlanDev\Parcel status application.doc Page 2 of 2 <br />Revision 11.26.2007 <br />