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acco <br /> Burnett County Subdivision Permit Application Fees(must <br /> w/o Spey $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form <br /> Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: Leif&Coleen Thompson <br /> Buyer: <br /> b <br /> Address: 27339 E Connors Lake Rd el, <br /> Address: R. <br /> Webster WI 54893 <br /> Phone: <br /> Phone: <br /> Original Parcel Information Kj <br /> 07-020-2-40-16-36-5 05-004-012000 <br /> Parcel ID#: 07-020-2-40-16-36-5 05-004-013000 Section 36 Township 40 Range 16 <br /> aC <br /> Original Description(or attach copy): Lots 1 &2 CSM#130 V1 P130 GL 4 a,� <br /> 0 <br /> A <br /> rnrn� <br /> b Current Zoning: RR2 Floodplain Y/N: Y Wetlands Y/N Y <br /> Lake/River Class: - <br /> c: ' <br /> D- <br /> e., Name of Water Body: Connors Lake Shoreland Agreement/SIPS Y/N: <br /> F. Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM to combine lots <br /> O <br /> 4 <br /> Acres: <br /> 0.90 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) O <br /> Proposed access to public road: <br /> v <br /> Proposed access to public waters to be provided Y/N: o <br /> If yes,describe access: � <br /> Signature of Owner: Caturn <br /> J r�C�M •p <br /> C�1i� Wr ► lf.J Date: / I 6• P <br /> Signature of Owner: Date: n <br /> 0 <br /> > Does parcel meet Zoning Requirements? Yes L <br /> No ��7ir <br /> N <br /> -e <br /> a > Does parcel require a Survey? Yes No <br /> 0 <br /> IQ p <br /> > Permit application fees submitted? 0 Amount$ �Q t9 Receipt# <br /> cyo <br /> r, IA Reconciles with Real Property Lister No Date: %k 110 i as <br /> O <br /> a <br /> a <br /> o. If not,explain: " ' <br /> et <br /> 0 <br /> y. <br /> Applicatio'. Approved i Denied Reason for Denial: <br /> Land Use: �tc����...• - a /S ZOZZ Date: <br />