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Dane County Department of Planning & Development <br />Application for Determination of Parcel Sta <br />400140 <br />Date: /(-/ q--©7 <br />Landowner information: <br />Name: it)'z j re, ry A 0�SaGr <br />Address: /9T-5- S y Ii n -- %'rr, City: 5.ce5 �i Z, Zip Code: 7• 7 <br />Daytime phone: — / �y <br />Fax: 7 j 4-7443 E-mail: / t�©? 0/te5t/ b �/f�`e " 6.0 <br />I -I - off to \ Iv o e6 -i11-1 is eED L 1 <br />f=c A 12Aecec__ J r 05 A <br />L' A iZ (" A r.)C C 1=C L<s i <--v I D <br />DY <br />A-10 € A - 0,6 C. C'_>, <br />: -�i P. <br />DANE Ca^, , Ny <br />NOV j 4.?007 <br />Li/ Vi6ICN <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: <br />Tax Parcel ID #: <br />LAVdescripti n of property: �— <br />1/4 of 514-) 1/4, Section 2 7 , Town of c /2'1 OR <br />Lot(s) <br />, Block , Plat of <br />Sketch map provided? Yes / No <br />Additional information (optional): <br />Name(s) of previous owner(s) (if known): <br />Comments lZPI F i /� ci fOr / ,%d i; ti ,��--�,t ij9ca- / /I�e �.-/r <br />e�F` nil er irlf;ni, /ey S7/ie.rjt' <br />I ' <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 />