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Fees(must accompany fo:m): <br /> Burnett County Subdivision Permit Application Sutaivisioew/o Survey: $50.00 <br /> Survey of Existing Parcel: SSo.00Aot <br /> and/or Pre-Application Form or Map Review Form Subdivision W/survey: $200.00+Sso.oanot <br /> Owner. Keith &Monica Peterson Buyer: <br /> tv <br /> Address:1203 Peterson Trail Address: m c <br /> Spooner WI 54801 <br /> Phone: Phone: <br /> Original Parcel Information <br /> Tax ID#: 18891 Section 36 Township 40 Range 14 Ur <br /> Original Description(or attach copy):GL 6 <br /> Current Zoning: RR11RR&loodplain Y/N•Y Wetlands Y/N:N Lake/River Class: <br /> Name of water Body:Big McKenzie Lake Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation YIN:N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> 2 Lot CSM <br /> Acres- <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,descn•be access: <br /> ➢ Doesparcel meet Zoning Requirements? yes No Fee Rec:309, <br /> Check#:610 9 7 <br /> ➢ Does parcel require a Survey? yes No <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> Applicatio Approved / enied Reason for Denial_ <br /> Land Use- Date <br /> e1c Ise , makP—S <br /> l►s .111oWe. i�i <br />