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Cancellation Of Notice

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CANCELLATION OF NOTICE

Use black ink

WHEREAS, the (Town of ) _________________________

in Dane County, Wisconsin, hereby cancels the notice that the

following parcels of real property contain no further land divisions for

non-farm residential development according to current Town land use

plan and zoning regulations. The land is described as follows:

(Use reverse side if more space is needed for the complete property description.)

Recording area

Name and return address:

The original notice was recorded on ________________________

(date) as document number _______________________ in the

office of the Dane County Register of Deeds.

PARCEL IDENTIFICATION NUMBER(S)

This Cancellation of Notice provides information regarding the status of the described property for land

divisions for non-farm residential development under Town/County policies in effect as of the filing date of this

document, and does not affect other restrictions on the use of the property. This Cancellation of Notice is

being recorded because of the following reasons (check one):

The Town land use plan pertaining to land divisions for residential development has changed.

The County zoning regulations pertaining to land divisions for residential development have changed.

Other (explain):

__________________________________________ ____________________

Signature of County/Town official

Date

__________________________________________ ____________________

Name printed

Title

This document was drafted by:

(print or type name below)

STATE OF WISCONSIN, County of _____________________________________

Subscribed and sworn to before me on______________________by the above named person(s).

Signature of notary or other person

authorized to administer an oath____________________________________________________

(as per s. 706.06, 706.07)

*Names of persons signing in any

capacity must be typed or printed

Print or type name: ______________________________________________________________

below their signature.

P&D form 6/2/2003

Title____________________________Date commission expires: _________________________.

Cancellation Of Notice

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