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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 Subdivision w/Survey: S200.00+$50.00/lot <br /> • <br /> Owner: ML Holst LLC Buyer: <br /> n <br /> Address: 852 138th St Address: 8 <br /> Amery WI 54001 <br /> :•G <br /> 715-821-2150tict <br /> Phone: Phone: <br /> gl <br /> Original Parcel Information W <br /> Parcel ID#: 07-002-2-37-19-34-1 01-000-012000 Section 34 Township 37N Range 19W <br /> ON <br /> Original Description(or attach copy): NE-NE lyq N of Trade River&W of East River Rd <br /> r <br /> Current Zoning: RR3 Floodplain YIN: Y Wetlands Y/N: Y Lake/River Class: <br /> no <br /> w Name of Water Body: Trade River Shoreland Agreement/SIPS Y/N: qj <br /> r. Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> New Parcel Information r- <br /> Proposed New Legal Description and Parcel Size: 5 Lot CSM <br /> Acres: 27.92 <br /> • <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 0 <br /> o <br /> Proposed access to public waters to be provided Y/N: E <br /> If yes,describe access: �� <br /> f: <br /> Signature of Owner: / Cfr^--• /1C4--- Date: 11/13/23 Signature of Owner: Date: o N <br /> a <br /> > Does parcel meet Zoning Requirements? Yes No G _# 6 0(?q ° <br /> m <br /> 0o > Does parcel require a Survey? Yes No <br /> a / �� ) <br /> °° > Permit application fees submitted? 0 Amount$ C P ,29 r ^Receipt# 1.6 <br /> V1 <br /> 0 Reconciles with Real Property Lister Yes) No Date: t g 17' 2a 23 <br /> a <br /> If not,explain: <br /> n <br /> n <br /> o <br /> C <br /> c. <br /> Applicatii.. •pproved / 'J enied Reason for Denial: <br /> Land Use:_79-240-0 `�""" Date: Z 7 ZOz.3 • <br /> too Gsl/11 L -- 474/ o 7 - S7o ,S. I <br />