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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/Survey: $200.00+$50.00/lot <br /> Owner: Johnson Enterprises PTSP Buyer: -v <br /> eD <br /> Address: 31423 Nelson Rd Address: Z, <br /> Danbury WI 54830 0 <br /> ok.fl <br /> C <br /> Phone: 715-656-7979 Phone: CP <br /> Original Parcel Information <br /> 07-032-2-41-16-12-4 01-000-011000 12 41 16 NZ <br /> Parcel ID#: _ Section Township Range <br /> O <br /> Original Description(or attach copy): NE-SE ex Hwy ROW <br /> O <br /> T <br /> Current Zoning: RR3 Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: <br /> Name of Water Body: NSA Shoreland Agreement/SIPS Y/N: <br /> 0 <br /> Farmland Preservation YIN: N Managed Forestry Law YN: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> 2 CSM 8 lots �' <br /> Acres: 38.58 CA <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: p <br /> y <br /> Proposed access to public waters to be provided Y/N: <br /> c:N\\ <br /> If yes,describe access: CP <br /> 7 ,k)� <br /> A gr.L i _L i <br /> Signature of Owner: ' v%%/,j, ' Date:c.C� <br /> Signature of Owner: - Date: o <br /> 3 <br /> -a <br /> > Does parcel meet Zoning Requirements? Yes No cje..4 ‘00f, ot <br /> -, <br /> %� G s $ <br /> N > Does parcel require a Suvey? Yes No <br /> °Q > Permit application fees submitted? ❑ Amount$ 60V t Receipt# <br /> 'V <br /> t- ® Reconciles with Real Property Lister No Date: b/7/.4 <br /> a <br /> If not,explain: <br /> P: <br /> n <br /> 2 <br /> G <br /> Ct <br /> Application: 'proved ' Denied Reason for Denial: <br /> yr_,7_,,e _�/P�zl-o6/0") <br /> 7 <br /> Land Use Cc// E?Z-/ Date: <br />