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Dane County Department of Planning BE <br />Application for Determination of Parcel Status <br />Date: 14.30. aoO7 <br />fa 2 IMP <br />nivecoutinPuteentcam <br />mer <br />Landowng information: <br />Name: ilasi S i 112 <br />Address: aHD 1 00104 S *' City: rf1:calt}on Zip Code: S351, <br />Daytime phone: d ``N 13 ri <br />Fax: C06.. K36 , y790E-mail: Sc v pa,p4s t 3hotky,a, I -CO/21 <br />Applicant information if different from landowner): <br />Name: C e.l�¢n a 'Son <br />Address: at 80 Rra,pstlio J r City: Wlo►.LtsoYY Zip Code: LS'Wici <br />Daytime phone: 408', yi3. Ll1OL <br />Fax: 6Dr. asi;�. OJDGj E-mail: p 8titrk,)o*w •COM <br />Relationship to landowner: Keskh &take, 3nLv/` <br />Are you submitting this application as an authorized agent for the landowner? Yes V.-No <br />Property information (be as specific as possible): <br />Property address: '7LO L) iktin Seal TY)&a.tma.r►! ... <br />Tax Parcel ID #: <br />03Ljf 080,-oil.- 85/0 -3 <br />Legal description of property: <br />N W 1/4 of N v 1/4, Section /1- b , Town of Mazo man; e.. OR <br />sec )-&-1. 8a5 F T F R N w ii4 <br />Lot(s) , Block , Plat of <br />Sketch map provided? Yes No <br />NV/t/L) <br />Additional information (optional): <br />Name(s) of previous owner(s) (if known): <br />Comments: Is pry p'Ci+sj �v i )ti.c4,42tat ? <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 />csrn a3a n <br />