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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 /> 1-0 <br /> b <br /> Owner: CD <br /> Kristi Foust Buyer: fD 2 <br /> Address: 2283 16 3/4 Ave Address: ' P <br /> Rice Lake WI 54868 `J <br /> by <br /> Phone: 715-418-1179 Phone: ca <br /> Orional Parcel Information <br /> Tax ID#: (A) (B) Section 15 Township 38 Range 14 <br /> Original Description(or attach copy): The NE 1/4 of the SE 1/4 of Section 15, Township 38N, <br /> Range 14W, Burnett County,Wisconsin, excepting the NE 1/4 thereof. G <br /> a <br /> Tax Parcel No. [(A) 07-008-2-38-14-15-4] [(B) 01-000-011000] <br /> Current Zoning: A2 Floodplain Y/N: N Wetlands Y/N: Y Lake/River Class. N.A. 39 e, <br /> Name of Water Body: N.A. Shoreland Agreement/SIPS Y/N: N 4it 1.. e <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Lot 1* 130,680 Square Feet 3 Acres <br /> Lot 2* 1,168,709 Square Feet 26.83 acres i <br /> * of new CSM 0 <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) ,.-i <br /> Y <br /> Proposed access to public road: Poquette Lake Road - Existing yC <br /> d <br /> Proposed access to public waters to be provided Y/N: N.A. <br /> If yes,describe access: <br /> 1.0 <br /> � W <br /> Signature of Owner: Date: �1 <br /> Signature of Owner: -7-4(i -W3 <br /> Fee Rec:?Ob-D— <br /> ). Does parcel meet Zoning Requirements? Yes No Check#: 2�3 <br /> c, <br /> > Does parcel require a Survey? Yes No d <br /> r <br /> a <br /> z <br /> 0 <br /> z <br /> Reconciles with Real Property Lister Yes No Date: _ w <br /> IffilCA Q. <br /> If not,explain: v m go C 0.n < 3 r- <br /> 0 m `� �. <br /> N <br /> < D 0 00 r= <br /> m N <br /> o C G <br /> Application: rove • Reason for Denial. E N <br /> Land Use: Date: /30�Z 3 <br /> t 0/1 f leA47/fir0 U.5/o4. `:.' (.... jj <br /> 2`T <br />