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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey: $200.00+$50.00/lot <br /> Boardwalk MHC LLC & Richard F & Nicole R Dubois Trust r. <br /> b <br /> Owner: Buyer: eD 2 <br /> v <br /> Address:3401 Frey Ct Lot 10 Address: CD 0 <br /> Marshfield WI 54449 c <br /> v1 Fal <br /> Phone: Phone: kl. w <br /> Orieinal Parcel Information <br /> —k. <br /> 07-020-2-40-16-20-2 02-000-012000, <br /> Tax ID#: 07-020-2-40-16-20-2 03-000-012000, Section 20 Township 40N Range 1 W <br /> 07-020-2-40-16-20-50- 15-930-030000, <br /> Original Descriiiti& 65r08tt6-aCL copy??-011100 Part NW&SW-NW,Lots 5-7 CSM#2010&Lots 3-4 CSM 2009 <br /> 0 <br /> F <br /> = <br /> eD <br /> Current Zoning: RR3 Floodplain YIN_ N Wetlands YIN: Y Lake/River Class: <br /> Name of Water Body:N/A Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N:N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: 2 Lot CSM <br /> Acres' <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C.. <br /> Proposed access to public waters to be provided Y/N: ,_ <br /> Jk <br /> If yes,describe access: 't, IC <br /> Signature of Owner: `— — Date: 14_2 j_ 2 3 cN "'i w <br /> Signature of Owner: kTh .Q f L Date: " <br /> /-*/ Al - <br /> Fee Rec: 3 C e% <br /> .v <br /> D Does parcel meet Zoning Requirements? Yes No Check#: (a,77o <br /> y <br /> Does parcel require a Survey? Yes No rn <br /> o <br /> r <br /> z <br /> c <br /> . <br /> tr <br /> v <br /> Reconciles with Real Property Lister ;►e No Date: b131 g1 `n— <br /> m <br /> v: <br /> If not,explain: Y <br /> T <br /> 0 <br /> z <br /> r <br /> Applicatio jApproved 77nied Reason for Denial: F, <br /> r <br /> Land U e: Date: 6 <br /> 5- C z e z 3 v <br /> g <br />