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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 /> ft <br /> Owner: Jerome Wilson Buyer: Jameson and Lydia Matrious B <br /> Address: 28562 Pardun Rd Address: 30272 4th Ave N P <br /> Danbury WI, 54830 Danbury WI, 54830 Cr <br /> co <br /> Phone: 715-791-0300 Phone: 715-791-4376 <br /> Original Parcel Information 00 <br /> Parcel ID#: 07-036-2-40-17-14-3 02-000-011000 Section 14 Township 40N Range 17W <br /> O <br /> Original Description (or attach copy): THE NORTHWEST QUARTER (NW 1/4) OF THE SOUTHWEST <br /> QUARTER (SW 1/4) OF SECTION FOURTEEN (14), TOWNSHIP FORTY(40) NORTH, (, • <br /> RANGE SEVENTEEN (17)WEST, IN THE TOWN OF UNION, BURNETT COUNTY, WISCONSIN <br /> Current Zoning: RR1 Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: N/A4 i' <br /> ,a Name of Water Body: N/A Shoreland Agreement/SIPS Y/N: N -rn" <br /> -a 1--- <br /> F'' Farmland Preservation Y/N: N Managed Forestry Law Y/N: N `� , <br /> F <br /> New Parcel Information ) <br /> Proposed New Legal Description and Parcel Size: THE EAST ONE HALF(E 1/2) OF THE EAST ONE HALF(E 1/2) <br /> OF THE NORTHWEST QUARTER (N 1/4) OF THE SOUTHWEST QUARTER (S 1/4)OF SECTION FOURTEEN (14), p ' <br /> TOWNSHIP FORTY(40) NORTH, RANGE SEVENTEEN (17) WEST, Acres: 10 <br /> IN THE TOWN OF UNION, BURNETT COUNTY, WISCONSIN <br /> (If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) a: <br /> Proposed access to public road: COUNTY ROAD F ''° <br /> Proposed access to public waters to be provided Y/N: N .-__, <br /> If yes, describe access: 4 <br /> PSignature of Owner: -' Date: I S .. / <br /> - "•i' <br /> z <br /> 'Si nature of 0 ai i:�Piiiv-ii1. ,s.` Date: -0 <br /> -,e- <br /> r Does parcel meet Zoning Requirements? Yes No _ <br /> c r Does parcel require a Survey? Yes No IIECEOVE [141 <br /> � <br /> Y Permit application fees submitted? ❑ Amount S 51-- r tCK#l uL <br /> IN Reconciles with Real Property Lister (}D No Date: lo/1 JQl LJ <br /> r <br /> e If not,explain: Burnett County <br /> I and Services Deaartntent <br /> a <br /> 'D <br /> n <br /> 0 <br /> CI. <br /> y Applicati: : Ass I • •'•d Reason for Denial: <br /> Land Use: <br /> O Z Zd Z Date: <br /> / <br />