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Fccs Imus accompany form: <br /> Burnett County Subdivision Permit Application Subdivision wio Survey: S50.00 • <br /> Sunny of Existing Parcel: S50.001101 <br /> and/or Pre-Application Form or Map Review Form Subdiviaionw•/Survey: 5200.00.550.00lot <br /> ���c� 1I >w 3� <br /> Owner:J an A t ice! Tit hT i 01 e/? Buyer: " g, <br /> Address:800'/ CCtia1Ly Ji'J• • Address: <br /> ti✓e-1,5 4-er, w 1 54/993 � <br /> Phone: 715-944i - 5 333 Phone: <br /> Original Parcel Information <br /> Tax[Ds:O'T-018-2-39-16-19-3-a'1-coo-oSet(aooction 19 Township—1,—Range <br /> Original Description(or attach copy): Cr��.2 o4 5E%s1 OC Sb✓1A, sec. 19 <br /> Current Zoning:RR 3 Floodplain Y/N: If Wetlands Y/N: r Lake/River Class. <br /> Name of Water Body: Shoreland Agreement/SIPS YIN: <br /> fFarmlaed Preservation Y/N: ` unaged Forestry I.aw YIN: ' 1 7q <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Lois -3f q OCIL vropOSCD/ C.S• - <br /> ea f/Les APe 9,$Z Acres eo-a-I <br /> Acres' <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: di cc-- t'7.[L^etr ,O C.T.4. "D " <br /> Proposed access to public waters to be provided Y/N: /Cl <br /> at <br /> If yes,describe access: e= <br /> LI <br /> IP. Signature of Ow li� <br /> Signature of Owner: Date: <br /> Fee Rec: <br /> i Does parrel meet Coning Requirements' )e. �'> _ Check tr: <br /> 9- o...5- <br /> �} <br /> Does parcel require a Survey' )'es Vv � <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> Application: roved ( nied Reason for Denial. <br /> Land • Date: <br /> IV/O/ZO Z.EZ <br /> ter-=. -•.:.,,.�....,... ...,- - - - --- ... ... _ <br /> JENNIFER L TAXMEN 9005 <br /> PH.718.888-5338 <br /> 8004 COUNTY ROAD D1!2918 <br /> WEHSTER,WI 54899 DATE v2� <br /> ►AY TO THE -� <br /> 1 sal ORDER OF _..it '-/- - "s .r.�/ - —.�/. a �y�!i v ..„-02P- <br /> 11 <br /> r'"� <br /> Art. <br /> 6 tl i SLAC <br /> (UREAL <br /> CREDIT <br /> .dat <br /> UN10N <br /> MEMO <br /> 1011 <br /> LOOK FOR FRAGG.OETEMONL FEATURES INCLUDING INF WWI,SCOW 010 NEAT.RE1GTIVF INK.D MA.OM BECK. <br />