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Fees(must accompany form): <br /> Subdivision w/o Survey: $50.00 <br /> Burnett County Subdivision Permit Application Survey for Existing Parcel: $50.00/lot <br /> Subdivision w/Survey:$200.00+$50.00/lot <br /> and/or Pre-Application Form or Map Review Form <br /> Owner: Genevieve Frazee Buyer: Genevieve Frazee <br /> Address: 29803 Saint Croix Trail Address: 29803 Saint Croix Trail <br /> Danbury,WI 54830 Danbury,WI 54830 0 <br /> Phone: (715)656-3003 Phone: (715)656-3003 n o <br /> Original Parcel Information <br /> Parcel ID#: 22528 Section 36,Township 41, North, Range 17 West <br /> t..i: <br /> Original Description (or attach copy): The Northeast Quarter of the Southwest Quarter(NE '/o SW '/4)ofSection Thirty-six(36),Township Forty-one(41)North, Range Seventeen(17) West, Burnett County, Wisconsin, <br /> excestin. the So .g,t narter SE '/4 thereof. o <br /> Currenng: ',1__ loodplain Y/N: No Wetlands Y/N: No Lake/River Class: N/A <br /> Na . of Water :ody: Shoreland Agreement/SIPS Y/N: <br /> g t <br /> Farm . d Preservation Y/N: No Managed Forestry Law Y/N: No (.6 <br /> c. <br /> ft <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: See attached Rider <br /> P <br /> NNI <br /> Acres: <br /> i <br /> (If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Saint Croix Trail <br /> Proposed access to public waters to be provided Y/N: No ta <br /> If yes,describe access: <br /> Signature of Owner: 4.,_! AG---- Date: /r'-.� -- z z <br /> Genevieve"F>"azee <br /> Signature of Owner: Date: <br /> Fee Rec:57.21,1 <br /> Check#: 122g3 <br /> r Does parcel meet Zoning Requirements? Yes No z <br /> M7, <br /> Does parcel require a Survey? Yes No o° <br /> cn r <br /> -H D <br /> D z <br /> 0 <br /> Reconciles with Real Property Lister ® No Date: \\--�-ZZ <br /> -°m <br /> F' <br /> rn <br /> If not,explain: .^ <br /> D <br /> ffi <br /> aCD C <br /> Applicatio : Approved / nied Reason for Denial: i g co 2tN <br /> CA 0 <br /> vo c <br /> me <br /> Land Use: ---- /// G� Date: m <br />