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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: Bonnie J. Gokey MAIL PERMIT TO: George W. Benson, Attorney at Lav <br /> P.O. Box 370, Siren, WI 54872 <br /> Address: 10300 Nero Road Telephone: 715 349-5215 <br /> Gr,nrnh„rq,, WT 54840 Phone: 715-689-2159 <br /> Orit=_inal Parcel Information <br /> 006-2432-02 000 32 38N 17W 9 <br /> Parcel Identification#: Section Township Range Z <br /> 0 <br /> Original Description (or attach copy): NW 1/4-EN 1/4, 32-38-17 % <br /> l <br /> O <br /> Current Zoning: Floodplai Y : Wetland Y <br /> Lake/River Classification: 3 Name of Water Body: AH---W "fz' NiA.Lfe'd L <br /> u� <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: see attached legal description <br /> Acres: 16 +/— <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: buyers own SW SW, 32-38-17 (County Line Road) <br /> Proposed access to public waters to be provided Y/N: No d <br /> m <br /> A <br /> If yes,describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> °o ➢ Does parcel require a Survey? Yes No 0 <br /> ➢ Permit application fees submitted? ] Amount M Receipt# °e <br /> , <br /> a <br /> oReconciles With Real Property Lister Yes No Date: 'A Q <br /> a a <br /> If not,explain: ed Q A e3t. to <br /> 0 <br /> H k <br /> Application Approved / enied Reason for Denial: c <br /> i <br /> Land Use: Date: <br /> 2/18/2003 <br />