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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 /> rA <br /> fo <br /> Owner: John & Barbara Bechtel Buyer: a B <br /> v <br /> : <br /> �,Address: 90 DX c 3O% Address: o c <br /> Webster WI 54893 c <br /> N F <br /> Phone: ~1k5'-3a8- pz � Phone: rt: <br /> idt <br /> CleiT <br /> Original Parcel Information <br /> Tax ID#: 07-012-2-40-15-10-5 15-128-116000 Section 10 Township 40N Range 15W <br /> 117000, 118000, 119000 <br /> Original Description(or attach copy): Lots 107-110 <br /> O <br /> 4 <br /> a <br /> A <br /> n <br /> Current Zoning: PUD Floodplain Y/N:N Wetlands Y/N: N Lake/River Class. <br /> 3.-- <br /> Name of Water Body: 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: CSM to combine existing lots <br /> „t :-1 <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: re <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe ac ess: QQ 00!S <br /> Signature of Owner: 7i Date: i / 9 )2 0 21-i 1 t) <br /> Signature of Owner: Date: O' lay/ ./4 <br /> > Does parcel meet Zoning Requirements? Yes No Fee Rec: �, �� <br /> Check#: 6075/�P <br /> > Does parcel require a Survey? Yes No o <br /> tz <br /> tt <br /> Reconciles with Real Property Lister Yes No Date: : <br /> If not,explain: <br /> 0 <br /> Application: Approved / D hied Reason for Denial- P) <br /> tr <br /> Land Use: Date: <br /> tz <br /> o <br /> /t ��jZD Z/ <br /> a <br /> a <br />