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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form or Ma Review Form Subdivision w/o Survey: $50.00 <br /> PP P Survey of Existing Parcel: $50.00/lot <br /> Subdivision w/Survev: $200.00+$50.00/lot <br /> Owner: Jeff Postler Buyer: <br /> CD <br /> 27693 COUNTY RD FF <br /> Address: Address: '* <br /> WEBSTER, WI 54893 <br /> 715-416-3353 <br /> Phone: Phone: <br /> Original Parcel Information <br /> Parcel ID#:07-036-2-40-17-26-4 04-000-011001 Section 26 Township 40 Range 17 <br /> Original Description(or attach copy): N'/2-SE'/4-SE'/4, Sec. 26-40-17 <br /> Except CSM No. 5146. C_ <br /> Current Zoning: RR-1 Floodplain Y/N:---N _Wetlands Y/N: N Lake/River Class: <br /> N/A <br /> d <br /> .> Name of Water Body: N/A Shoreland Agreement/SIPS Y/N: N <br /> -a <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> ° <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: We are submitting a new CSM that <br /> creates two new lots. <br /> Acres: 12.9 A <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Access provided through adjoining land owned by Postler <br /> Terry Larsen <br /> Proposed access to public waters to be provided Y/N: N <br /> If yes,describe access: \ <br /> Signature of ON+ner: Qe� Date: 1f--1� <br /> 'Aug of Vwner: uare: ° <br /> 3 <br /> C <br /> M <br /> Does parcel meet Zoning Requirements? Yes No <br /> N ➢ Does parcel require a Survey? Yes No W <br /> ' ➢ Permit application fees submitted? ❑ Amount$ �QQ � Receipt# N <br /> ❑ Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> a <br /> 0. <br /> i9 <br /> A <br /> n <br /> O <br /> p, Applicati pproved / enied Reason for Denial: <br /> Land Use: Date: <br /> at70t4 4CCe 55. <br />