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s <br />Vl ^ <br />Date: I J ( / <br />l <br />LandownAr information: ''!! <br />Name: Vera' 6-02.251-1- - t) 4 14Ni <br />Address: 4 g 3 Q.e( City: ��Q c Zip Code: <br />Daytime phone: BtS41 <br />.6 Dane County Department of Planning & Development <br />Application for Determination of Parcel Status <br />Fax: <br />E-mail: <br />Applicant information (if different from landowner): <br />Name: i1c.T t pyvtrC CowfWLT1 a1J . - <br />Address:46Z7 ,eAce L/1cLE 1249 City: Get -out Zip Code: �3SZ7 <br />Daytime phone: 6Q43 41, 33 <br />Fax: (d7e ` S2S'-60/a E-mail: <br />Relationship to landowner: <br />Are you submitting this application as an authorized agent for the landowner? Yes No <br />Property informati n (be .a� specific as possible): <br />Property address: '33 Aset. -rrn 2-tQ . <br />Tax Parcel ID #: OZ-6f « t / ' 'L j / - 2C O - g <br />Legal descriptio of property: <br />tja 1/4 of / L 1/4, Section z-5 , Town of -PUN 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: <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 />