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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+$50.00/lot <br /> b <br /> Owner: Kenneth Jr. & Penny Bistram Buyer: Adam & Kayla Bistram <br /> 2926 State Road 87 23391 South Williams Road 2 <br /> Address: Address: P <br /> Grantsburg, WI 54840 Grantsburg,WI 54840 c <br /> to <br /> 715-338-9449 <br /> Phone: 651-368-5191 <br /> Original Parcel Information <br /> Parcel ID#: 07-034-2-37-18-31-3 03-000-011000 Section 31 Township 37N Range 18W <br /> Original Description (or attach copy): The Southwest Quarter of the Southwest Quarter <br /> a <br /> et <br /> 4)...."4;- <br /> 44 <br /> Current Zoning: Floodplain Y/N: Wetlands Y/N: Lake/River Class: - ' I <br /> a Name of Water Body: Shoreland Agreement/SIPS Y/N: <br /> .a <br /> ;' Farmland Preservation Y/N: Managed Forestry Law Y/N: 3 <br /> a <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: The North 430 feet of the Southwest Quarter of the <br /> Southwest Quarter, Section 31,Township 37 North Range 18 West,Town of Trade Lake, p <br /> i <br /> Burnett County, Wisconsin. Acres: 13 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) d <br /> T <br /> ro <br /> Proposed access to public road: Range Line Road <br /> k* <br /> Proposed access to public waters to be provided Y/N: N/A i&. , <br /> If yes, describe access: <br /> Signature of Owner; <br /> 7 <br /> metal R__Ak Date: //f67 z <br /> Signature of Owner: F';A(\:'✓l _Li _ (Z---,(Z---, '`�,�,�, Date: ! ( / 21 Z 1 0 <br /> i Does parcel meet Zoning Requirements? Yes No gel-- 0(Zi'lA <br /> .-,c <br /> N ➢ Does parcel require a Survey? Yes No <br /> e c4/6 a °° i'L <br /> Permit application fees submitted? ❑ Amount$ -'0? 'I te Sc,7 Receipt# Q <br /> CI Reconciles with Real Property Lister YID No Date: \\I\°+I 1 <br /> a If not,explain: <br /> a <br /> n. <br /> n <br /> 0 <br /> °' Application / Dd Reason for Denial: <br /> Land Use: Date: /G7?OL/ <br /> ftd/ w ,i490( > hs cley f% pOqetoC Ss RousertsoLe <br /> Z://a . <br /> S "L- / <br /> 5 e back S are, Me.74' 3: Qct i/ci H all 4 or}1'lt arr el fr1 eeiS on GIziorSS„ <br />