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�— Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form Subdivision w/o Survey: $10.00 <br /> p� Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: Jerry Paulson and Elizabeth Snow <br /> Address: c/o George W. Benson, Attorney at Law <br /> P.O. Box 370, Siren, WI 54872 Phone: 715/349-5215 <br /> Orieinal Parcel Information b <br /> A <br /> Parcel Identification #: 040-3633-04 6003 <br /> Section 33 Township 39N Range 19W <br /> 0 <br /> Original Description (or attach copy): _ SWa SE', .. <br /> 90 <br /> o Current Zoning: unzoned Floodplain Wetlands Y/N o <br /> Lake/River Classification: Name of Water Body: C� <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: three parcels: <br /> 1) N� of SW; SEQ 2) SE; of SW4 SE; 3) SW; of SWQ SEa �) <br /> this sale complete <br /> dog.#367951 Acres: 20/10/10 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> #1 Gile Road <br /> Proposed access to public road: #2 and #3 Ferry Road <br /> Proposed access to public waters to be provided Y/N: no <br /> d <br /> If yes,describe access: <br /> I <br /> ➢ Does parcel meet Zoning Requirements? Yes No 0 <br /> N � <br /> e ➢ Does parcel require a Survey? Yes No n <br /> � o <br /> Qo <br /> ➢ Permit application fees submitted? AmountReceipt#$ 9 <br /> �— C <br /> A <br /> ❑ Reconciles With Real Property Lister Yes N Date: <br /> a <br /> If not,explain: d <br /> o <br /> n. <br /> N <br /> ll.l <br /> i <br /> Application(Approved enied Reason for Denial: <br /> Land Use: Date: y_3 . <br /> 2/18/2003 <br />