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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 /> Owner: Rodney Wilson = 2 <br /> Buyer: et, g <br /> d <br /> Address: 13793 State Rd 35 S Address: A p <br /> Danbury WI 54830 <br /> Phone: Phone: <br /> Original Parcel Information <br /> Tax ID#: 07-032-2-41-16-28-5 15-588-085000 Section 28 Township 41 N Range 16W 51 <br /> Original Description(or attach copy):Lots 1-4 BIk 14 Peet's 1st Add to Danbury <br /> O <br /> a <br /> ee <br /> n <br /> Current Zoning: RR1 Floodplain Y/N:N Wetlands Y/N: N Lake/River Class. r <br /> Ii <br /> Name of Water Body:N/A Shoreland Agreement/SIPS Y/N: II <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> E. <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) yy� <br /> Proposed access to public road: k <br /> C <br /> Proposed access to public waters to be provided Y/N: at <br /> If yes,describe access: 6�' <br /> > Does parcel meet Zoning Requirements? Yes No Fee Rec: ���mo <br /> : Check#:to cerj " <br /> > Does parcel require a Survey? Yes No <br /> 4' <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> Applicatio I Approved / I enied Reason for Denial! q, / <br /> Land U Date: l �2 20Z3 } <br /> Se,e- (Oa/Vact'r /-ld,/ o c 7 ?Z E3a s <br />