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Fees(must accompany form): <br /> Burnett County Subdivision permit,Application $50.0,0 <br /> Survey of Existing Parcel:s5o o1rot <br /> and/or Pre-Application Form or Map Review Farm S ionwes :S2oa00.+ ,.00not <br /> Owner: Timothy Shimko Buyer Mark Goheen <br /> Address:1121 37th St A <br /> 1521 Timber Edge Dr z <br /> ddress: o c <br /> Hudson WI 54016 McKinney Tx 75072 <br /> Phone: Phone- ' <br /> (Id&al Parcel Information <br /> Tax ID#: 07-026.2�39-15-28-5 05-003-025000 Sectlon 28 Townsbipr 3g ange T 5 <br /> 07-026 2-39-15-28-r 05-003-026000 <br /> Original Description(or attach copy): GL 3&Lt 1 GSM M P255 <br /> Current Zoning.RR1 Floodplai#YIN,e Y Wetlands YA4s Y LakemVee <br /> Name of Water Body:Big Sand Lake Shoreland Agreement/SIPS Y/N <br /> Farmland PreservationYIN: Managed Forestry Law YIN: N <br /> New Parcel Information <br /> .Proposed New Legal Description and Parcel Size: CSM <br /> Aere� yy <br /> (if parcel Is to be surveyed;provide preliminary map. See attached for preliminary map requirements.) <br /> �4 <br /> Proposed access to public road- <br /> Proposed access to public waters to be provided.YIN:If yes,describe access <br /> Fee Pxc:. <br /> Uoespareel tneei'ZonfngRequ/retamts2 Yes No <br /> Check#s <br /> ➢ Does parcel require a Survey? Yes No <br /> Reconciles with.Real Property Lister Yes No Date: <br /> If not,explain. <br /> Application: Approved I Denied Reason for Deni9lc <br /> Land Use; Date: <br />