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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 or Map Review Form Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: Betty Leef Buyer: Thomas J. Ennis / Thomas B. Ennis g <br /> Address: 2135 Acorn Road Address: 27075 West Benoit Lake Road p <br /> Webster, WI 54893 Webster, WI 54893 <br /> m <br /> Phone: 715-635-2371 Phone: 715-520-2991 <br /> Original Parcel Information p <br /> Parcel ID#:07-024-2-39-14-04-1 04-000-011000 Section 04 Township 39N Range 14W N <br /> Original Description (or attach copy): SE 1/4 NE 1/4, 04-39-14 Except V. 397, Page 385 4 <br /> a <br /> ,g <br /> X.• <br /> Current Zoning: Floodplain Y/N: Ale Wetlands Y/N: Ve 7 Lake/River Class: <br /> el <br /> Name of Water Bod1 <br /> Y Shoreland Agreement/SIPS Y/N: <br /> .03 r <br /> el' Farmland Preservation Y/N: Managed Forestry Law Y/N: 1h- <br /> aa <br /> New Parcel Information 5-1 <br /> Proposed New Legal Description and Parcel Size: see attached legal description <br /> F\e <br /> Acres: 10 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) C7 <br /> a <br /> n <br /> Proposed access to public road: West Benoit Lake Road <-0 <br /> R) <br /> Proposed access to public waters to be provided Y/N: N <br /> 'P'- <br /> If yes, describe access: <br /> .90 <br /> Signature of Owner:_ 21,1'4' UtriA A"- Date: <br /> Betty Leef <br /> Adam C. Benson, Attorneyfor 09-20-21 <br /> Signature of Owner: Date: <br /> ➢ Does parcel meet Zoning Requirements? Yes No ( (�+ (� �/] (� <br /> L'...s ©'' IEI V IE <br /> c ➢ Does parcel require a Survey? Yes No , <br /> P.. egli <br /> CIV <br /> > Permit application fees submitted? 0 Amount$_5-641)' aelP Ip b <br /> 2021 <br /> ®Reconciles with Real Property Lister Yes; No Date:clpa'al - <br /> o, If not,explain: Burnett County <br /> flLand Servings Department <br /> 7t <br /> e� <br /> n <br /> 0 <br /> °• Application: . pproved Denied Reason for Denial: <br /> CM <br /> Land Use:• 9' 03 2[9 a Date: <br />