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Fees(must accompany form): <br /> Subdivision w/o Survey: 550.00 <br /> Burnett County Subdivision Permit Application Survey for Existing Parcel: $50.00/lot <br /> Subdivision w/Survey:$200.00+550.00/tot <br /> and/or Pre-Application Form or Map Review Form <br /> Owner: Paul J. Armstrong and Donna J. Buyer: Daniel S.Howland and\Kristina R. <br /> Olson-Armstrong Joint Declaration of Trust Howland = b <br /> Address: 2022 Burlison Drive Address: 2728 West River Parkway c <br /> Urbana,IL 61801 Minneapolis,MN 55406 Ft o <br /> _Phone: Phone: (612)339-8811 Vic <br /> Original Parcel Information 1 V <br /> ,�d 21533 b <br /> Parcel ID : 21523 4 Section 22,Township 41N,Range 15W <br /> Original Description(or attach copy): ti <br /> p Government Lot One(1),Section Twenty-two(22),Township N `13 <br /> Forty-one(41)Nop . Range Fifteen(15) West,Town of Swiss,Burnett County,Wisconsin N <br /> Current/onintn " oodplain Y/N: Yes Wetlands Y/N: Yes Lake/River Class: <br /> g <br /> A <br /> Name of Water Body: Little Round Lake Shoreland Agreement/SIPS YIN:No T3 <br /> Farmland Preservation Y/N: No Managed Forestry Law Y/N: No <br /> _ (3 <br /> New Parcel Information <br /> i <br /> Proposed New Legal Description and Parcel Size: See attached Rider and Map. Certified Survey Map to be <br /> prepared and recorded after Deed conveyance to adioiningproperty owner E r: <br /> i <br /> ____ Acres: .19 ik. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public Road: Yes. through adjoining property d <br /> Proposed access to public waters to be provided Y/N: No <br /> If yes,describe access: <br /> tti <br /> / U; <br /> Signature of Owner: Date: <br /> P ul J. Armst-on ,Truste <br /> Signature of Owner: '�,L,Z�`iv a„._� <,, -Date: 'f / 2 0 z <br /> onna J.O son-Armstrong,Trust e <br /> Fee Rec:5 ( <br /> Check#:ii_" ` / <br /> Does parcel meet Zoning Requirements? Yes No g <br /> m''' <br /> Does parcel require a Survey? Yes No ° <br /> z <br /> c <br /> Reconciles with Real Property Lister Yes ' No Date: .�/`1/�; re <br /> If not,explain: R <br /> ei 1 <br /> fi..z K <br /> Application: Approved / Denied Reason for Denial: zco 3° n" <br /> y // /zo - fe eni4k. ho�/4itQ/oo <br /> Land Use: /S Z &Z Date: ,O 10 ell'l x /Q ; ��33 3 _ <br />