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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survev: $200.00+$50.00flot <br /> Albert Sommerfeld Estate <br /> Owner: Buyer: ,y <br /> Address: 2313 Rolling Green RD> Address: �. <br /> �Ry <br /> i <br /> Spooner WI> 54701 <br /> Phone: 715-559-2989 Phone: <br /> Original Parcel Information <br /> Parcel ID#:07-024-2-39-14-33-1 02-000-011000 Section-3_Township 39 Range 14 west <br /> O <br /> Original Description(or attach copy): NW NE Section <br /> i. <br /> Rezm& MAP-I '-oz. npPyw } -Z <br /> V Current Zoning.�X AC��Floodplain YIN: N Wetlands YIN: N Lake/River Class: NA <br /> V <br /> aName of Water Body: NA Shoreland Agreement/SIPS Y/N: NA <br /> .. Farmland Preservation Y/N: Y Managed Forestry Law Y/N: N <br /> New Parcel Information ,75 P, I7q,-lg <br /> Proposed New Legal Description and Parcel Size: Part of the NW quarter of the NE quarter of � <br /> section 33_ township 39 N. range 14 west. town of rusk, county of Burnett, state of WI. <br /> Lot 1 of CSM. Acres: 4.44 ac. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: yeS d <br /> m <br /> Proposed access to public waters to be provided Y/N: N <br /> If yes,describe access: <br /> Signature of Owner: Dan Sommer a Date: 4/7/2015 t� <br /> Signature of Owner: Date: <br /> C <br /> > Does parcel meet Zoning Requirements? Yes No <br /> o > Does parcel require a Survey? Yes No <br /> CGS <br /> °O > Permit application fees submitted? Amount$ ' Receipt# <br /> t <br /> C, ❑Reconciles with Real Property Lister Yes No Date: — <br /> m <br /> If not,explain: ` <br /> a <br /> Pezune MRS-15 `' <br /> Applicatio Approved / eni-4 Reason for Denial: <br /> ZONING <br /> Land Use: Date: S /� <br />