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be Dane County Department of Planning & Development <br />Application for Determination of Parcel Status i G ���IN� <br />NOISING <br />Date: // - 2 01 <br />Landowner information: <br />Name: /(//CA( Ac/, <br />Address: 3/ 3' &f'/86A-sva al ("VT -Ay: /f c, '/ ,C ,/<Lip Code: <br />Daytime phone: „2 S-Z " %O (o <br />Fax: E-mail: <br />LOO ,-. _. A.f N <br />RLNi1O3 2NVO <br />Co //o3 <br />Applicant i formation (if different from landowner): <br />Name: VN/L ,CNfl '/U6 <br />Address: 078A`j CeESCE 1 Q/(City: pitF/m..,Q,v4 Zip Code: <br />Daytime phone: (ocsg- g ?i3 cc,oi 3 <br />Fax: E-mail: <br />Relationship to landowner: Pieo.Sla‘ c ,,%j ,8(d Krr.A. <br />Are you submitting this application as an authorized agent for the landowner? Yes NoK <br />Property information (be as specific as possible): <br />Property address: 2 83 ( � sCEir/T _ plc IA f6 C,i / <-35 <br />Tax Parcel ID #: O . Vd /o/ o <br />Legal description of property: <br />1/4 of 1/4, Section , Town of OR <br />Lot(s) , Block , Plat of <br />Sketch map provided? Yes k 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 />