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Dane County Department of Planning & Development <br />Application for Determination of Parcel Status <br />Date: 7/2/h 00 7 <br />Landowner information: <br />Name: 5-re C, a..of C key. yi 8 e r, e o vt <br />Address: 4.o1 1 M TerP4r.ere A-0e, City:Arl:t,-ton 14 ee74,45 Zip Code: IL Coco at ,l 35 7 <br />Daytime phone: f(`f7- 6 So b 3 6'7 <br />Fax: E-mail: <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: 3 Lt 4 Ma /1et"ot A✓� 51-6 jitt-a , L4/1 935-8'1 <br />Tax Parcel ID #: 02. /D 6 1 0 - 2- 6 (.F -- ( 0 1 1 — <br />Leal description of property: hh <br />1/4 of St 1/4, Section Z6 lJ , Town of u hkt <br />Wes-tL <br />Lot(s) A- , Block , Plat of ToCk EI r'+ perk <br />Sketch map provided? Yes No K <br />OR <br />Additional information (optional): <br />Name(s) of previous owner(s) (if known): <br />Comments: Nee() et e M l V -t6Od e 4- w eh (a -(" ups c frees -red <br />el S Yes / o -t' cc.s c4 re (cete4) hK w1 <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 />