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Dane County Department of Planning & Developm EC it.iVED <br />Application for Determination of Parcel Status <br />Date: ;6 to--02, <br />OCT 1 0 2008 <br />DANE COUNTY PLANNING & DEVELOPMENT <br />Receipt # <br />Landowner information: <br />Name: S TE d A *47 R c'tF r c, 2. <br />Address: 1 e, Dc., City: \I GEZ3z) 1.} fy Zip Code: S3.s1;3 <br />Daytime phone: S4-7•- 4-(,4-p <br />Fax: GOB-244-E5 E-mail: R2r)..s ,\/% .@ l bL :caot� <br />Applicant information (if different from landowner): <br />Name: 0oiz-L. 00. Gu -vt.A Vk6M ' 1 fJC <br />Address: 'Z 9 _ City: tvl21,]7(S01J Zip Code:r."..,-.51" <br />Daytime phone: poi Z74- - o 41 C� <br />Fax: (yob- E-mail: 1€ests►s01.1v(z-is 00cc Far1rt1-E)t -6nWl <br />Relationship to landowner: C i)-y &c. o1'�_ <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: <br />Tax Parcel ID #: <br />Legal description of property: <br />r\. E 1/4 of Mt : 1/4, Section '2 , Town of s(FV_t1,3C/D)s,‘_f. OR <br />Lot(s) , Block , Plat of <br />Sketch map provided? Yes No <br />Additional information (optional): <br />Name(s) of previous owner(s) (if known): <br />Comments: r ' t= -i_ �: t :.au t ST+rc s t s <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 Revision 11.26.2007 <br />