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)t� Sign Vert tied: St)2..!l < � ��� / c� rx 7 / <br /> �(iC:-bU�t-t;(iU-Il3;C U13OhC ��U1C )l� <br /> Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w°Survey: ;50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form subdivision Survey: 5200.00-$50.001ot <br /> owner: Kristie Henning & Donna Chell Buser: Donald I Chell & Nicole Olthafer <br /> 3 <br /> address: 22163 Spirit Lake Rd E Address: 22163 Spirit Lake Rd E z <br /> Frederic, WI 54837 Frederic, WI 54837 c <br /> Phone: (715)431-0249 & (715)431-0124 Phone: (608)335-6105 & (608)658-5398 & <br /> Original Parcel Information <br /> Parcel ID#: 07-034-2-37-18-02-5 Section 05 Township 002 Range 012000 <br /> Original Description (or attach copy): PCL IN GOV LOT 2 DESC DOC #343227 <br /> Current Zoning: a-A4-GS-Floodplain Y/N: Y Wetlands Y/N: Y Lake/Riser Class:. <br /> Name of eater Bodv4.-SP44±a/ /V©kfQi Shoreland Agreement/SIPS ti'/N: N <br /> Z. <br /> 7-7 Farmland Preservation Y/\: N Managed Forestry Law 1'/\: <br /> r+ cill <br /> New Parcel Information -4T- ,r,, <br /> Proposed New Legal Description and Parcel Site: <br /> 1/2 of PCL IN GOV LOT 2 DESC DOC #343227 q <br /> � PWest 20 acres, north of Spirit Lake Rd E o <br /> n <br /> Acres:20 d <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> m <br /> Proposed access to public road:existing driveway to Spirit Lake Rd E koQ <br /> Proposed access to public waters to be provided V/N: N <br /> If yes,describe access: <br /> m <br /> Signature of Owner: -,`,,:,-,r`;F e-.,-,,,:,.;..i7,... Date: 08-18-2021 z <br /> Signature of Owner: y a Date: 08-17-2021 <br /> . Does parcel meet Zoning Requirements? Yes No l)+ <br /> 04 <br /> ,t <br /> o Does parcel require a Survey? Yes :Vo <br /> 0 <br /> 0 <br /> r..-- --) .- Pe mit application Pecs submitted? ❑ Amount S Receipt <br /> Mt— ® ReEanciles with Real Property Lister IMO No Date: g-,z4 -at <br /> m <br /> If■�tzplain: <br /> nnc o0 <br /> g. c~'' m <br /> V ~ <br /> zkil A f;i�a do Approved Denied Reason for enial: <br /> W 8' 2S' ZoZ/ <br /> Land.`�he: .�_� / Date: <br /> r� c s ni 4r V R- 2l-!/6 flus is <br /> /oSwce e. <br /> �f- emtvlce. <br /> ,,sl€ 1P QF' Is' io� Va / d. Sy �HdQ1'iJake <br /> lol,. <br />