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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 Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: Greg Johnson Buyer: ,.d <br /> et <br /> Address: 31423 Nelson Rd Address: @ <br /> Danbury WI 54830 <br /> `-G� <br /> Phone: Phone: <br /> Original Parcel Information }J <br /> -C <br /> Parcel ID#: 07-032-2-41-15-07-2 01-000-011000 Section 07 Township 41 Range 15 ,. <br /> O <br /> Original Description(or attach copy): NE-NW Lying S &E of Hwy 35 a <br /> CD <br /> .d Current Zoning: Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: <br /> to Name of Water Body: N/A Shoreland Agreement/SIPS Y/N; <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: Y <br /> 0 <br /> New Parcel Information �9 <br /> Proposed New Legal Description and Parcel Size: CSM - 3 Le+ <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: v <br /> as <br /> R <br /> Proposed access to public waters to be provided Y/N: <br /> 15- <br /> If yes,describe access: �Q� <br /> Signature of Owner:_4Date: a//"/y 7 N <br /> Signature of Owner: Date: c <br /> 3 <br /> > Does parcel meet Zoning Requirements? Yes No G osg►4( CD <br /> a > Does parcel require a Survey? Yes No�-t <br /> o <br /> P <br /> °Q > Permit application fees submitted? ❑ ,S C/Amount$ , Recei t# <br /> U� <br /> r 21 Reconciles with Real Property Lister No Date: (0/o�./O9a, VJ <br /> 0 <br /> °" If not,explain: <br /> r <br /> 0 <br /> a <br /> Applicatio . pprove9Denied Reason for Denial: <br /> Land Use: Date: a 2.e9 Z Z <br />