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1,0451 C5�s <br /> Fees(must accompany farm): <br /> Burnett.County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> and/or Pre-A licafiion Form Survey of Existing Parcel: $50.00/lot <br /> PP Subdivision w/Survey S200.00+$50.00/lot <br /> Owner: ML Hoist LLC Buyer: <br /> ,z <br /> Address: 852 138th St Address: <br /> Amery WI 54001 0 <br /> Phone: 715-821-2150 C <br /> Phone: <br /> Original Parcel Information <br /> k) <br /> Parcel ID#: 07-040-2-39-19-32-1 01-000-011000 Section 32 Townshi 39N Range 19W �0 <br /> p <br /> NE-NE, SE-NE 1 <br /> Original Description(or attach copy): 1 <br /> r, <br /> n <br /> 3 <br /> Current Zoning: RR3 Floodplain Y/N: N Wetlands YIN: N Lake/River Class: (1 <br /> LI Name of Water Body: Shoreland Agreement/SIPS Y/N: <br /> a <br /> Farmland Preservation YIN: N Managed Forestry Law YIN: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM <br /> 1> <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> a <br /> Proposed access to public waters to be provided YIN: <br /> �� <br /> If yes,describe access: �) �G <br /> l�l � <br /> Signature of Owner: At"--- S---- Date: 9/6/22 <br /> Signature of Owner: Date: o <br /> 0 <br /> z <br /> Does parcel meet Zoning Requirements? Yes No G # 606 KC <br /> N <br /> o > Does parcel require a Survey? Yes No <br /> a OQ <br /> P° > Permit application fees submitted? 0 Amount$ 7 9O r Receipt# <br /> 0 <br /> ®Reconciles with Real Property Lister No Date: ►Q-IC)-as .-c.. <br /> a <br /> If not,explain: .JtS- <br /> m <br /> n <br /> o <br /> C <br /> ti <br /> Applicatio :pproved / 1 enied Reason for Denial: <br /> Land Use: Date: /��7/ Ze'e-2 <br />