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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-A lication Form Subdivision w/o Survey: $10.00 <br /> PP Subdivision w/Survey:S 100.00+S I5.00/lot <br /> Owner: Estate of Helen Berglund <br /> C/o Dale Berglund, Personal Rep. <br /> Address: PO Box 4212 Local Contact : Patsy <br /> Pa m S rings, CA. 92264 Gustafson - Burnett Dairy <br /> Phone: 715-689-2467 <br /> A <br /> Ori¢inal Parcel Information B <br /> 034-1519-03 500 19 37 18 <br /> Parcel Identitic tion# 034-1530-01 100 Section 30 Township 37 Range 18 z <br /> &200 P <br /> Original Description( r attach copy): _118 acres- SE SE, Sec.19-37-18• NE NE UJ <br /> Sec. 30-37-18; W NE except S 17 3/4 rods of W 18 ro 9s, Sec. a <br /> �0-37- o <br /> 9 Current Zoning: _Aq . Floodplain Y/N: Wetlands Y/N: <br /> V Lake/River Classification: Trade Rive r <br /> �' Name of Water Body: <br /> w (4VZ <br /> 3 <br /> New Parcel Information <br /> Po osed New al ri tion and Parcel Size: Parcel 1 ) NE NE, Sec. 30-37-18 � <br /> lu acres) ; Par eI 2) NW NE excep ro s of W IS ro s, �N <br /> Sic. 30-37 18 =, H�,f.,: e . ,2QSt,; eet 99 ,the,SE. 41!+:r, <br /> ec. - acres arce ' g o <br /> the W 209 ,eet, Sec. 19-37-18 (39 acres) e - 42 . . <br /> Acres: <br /> (If parcel is to be st rveyei provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Carl Berg Rd. and Cedar Point Road <br /> d <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe ac ess: <br /> c <br /> 0 <br /> D Does parcel m et Zon'ng Requirements? Yes No <br /> ➢ Does parcel re uire a Survey? Yes No 9 <br /> v <br /> ➢ Permit applica ion je submitted? ❑ Amount S Receipt# <br /> u <br /> ❑ Reconciles Wi h Real Property Liste Y No Date: <br /> a <br /> If not,explain <br /> rs <br /> N lei yk'A� l <br /> Applicata . Appove / Denied Reason for enlah o o / <br /> w to <br /> L � <br /> Land Use: Date: 8'2'0-5- <br /> 0 <br /> 2/18/2003 <br /> 0 <br /> p o <br />