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Dane County Department of Planning & Development <br />Application for Determination of Parcel Stat'RECEIVED <br />seas <br />Date: j i-it ao <br />Landowner information: <br />Name: <br />Address: 1Zp1o(, Shag tCity: S}a vYAAa,• Zip Code: S <br />Daytime phone: fa O8 bloc\ - b So 1 <br />Fax: to o - 2 fl ^ a b O E-mail: IVM a L c\v-k-- 8 cam, �-c <br />SEP 5 2007 <br />DANE COUNTY PLANNING & DEVELOPMENT <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 />06k.\ <br />Tax Parcel ID #: <br />Legal description of property: <br />1/4 of 1/4, Section , Town of OR <br />Lot(sf I- / , dock Z , Plat of CAv.k .-I--,S AA\\c> <br />y2 \O <br />Sketch map provided? Yes No`X <br />Additional information (optional): <br />Name(s) of <br />previous owner(s) (if known): <br />Comments: ``lest v� \ � rs tact 4tc r� sS c S\KVsk otr) <br />fV ‘ :art. \ 5 a. 1, C e,rs N" per,'1 'VV' <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:\PIanDev\Zoning\ZLR\Forms, Applications & Informational Materials\Parcel status application.doc <br />