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Fees(must accompany torm): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Eydsting Parcel: $50.00/lot <br /> and/or Pre-Application Form I Subdivisionw/Survey. $200.00+$50.0011« <br /> Owner: Corey W. and Renee J. Nelson Buyer: Albert L. Kasdorf ., <br /> A <br /> Address: 8169 Park Street Address: 25669 State Road 35 3 <br /> z <br /> Dan WI 54810 Webster, WI 54893 <br /> Phone: (715) 866-4700 Phone: (715) 566-3321 <br /> G <br /> Original Parcel Information <br /> Parcel ID#:07-016-2-39-17-12-4 01-000-013000 Section 12 Township 39N Range 17W <br /> O <br /> Original Description(or attach copy): The West Half of the Northeast Quarter of the <br /> Southeast Quarter (W 1/2 NE 1/4 SE 1/4) of Section Twelve (12), Township Thirty-nine (39) n <br /> North, Range Seventeen (17) West. _ <br /> ctm <br /> .,y Current Zoning: RU Floodplain Y/N:__UQ Wetlands YIN: NO Lake/River Class: <br /> v <br /> Name of Water Body: N/A Shoreland Agreement/SIPS Y/N: NO <br /> a � <br /> Farmland Preservation Y/N: NO Managed Forestry Law YIN: NO <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: The East One–Hal f of the West One–Hal f of the <br /> Northeast Quarter of the Southeast Quarter (E 1/2 W 1/2 NE 1/4 SE 1/4). Section Twelve (12). <br /> Township Thirty-nine (39) North, Range Seventeen (17) West. Acres: 10 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Hel sene Rcad d <br /> Proposed access to public waters to be provided Y/N: NO n <br /> 1 <br /> If yes, describe access: lP� <br /> Signature of Owner: ! Date: <br /> Corey W. Nelson <br /> Signature of Owner: Date: =-r—luf–,e J- Nplqon <br /> /� 3 <br /> V <br /> e <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> o ➢ Does parcel require a Survey? Yes No <br /> 0° ➢ Permit application fees suhmitted? I� Amount g�Vu�� Receipt# <br /> / \ <br /> ❑ Reconciles with Real Property Lister Yes No Date: <br /> v � <br /> If not,explain: C <br /> 0 <br /> a C � <br /> j <br /> Applicata Approved / enied Reason for Denial: <br /> I <br /> LandUse: Date: <br />