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Fees(must accompany form): <br /> Subdivision w/o Survey: $50.00 <br /> Burnett County Subdivision Permit Application Survey for Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey:$200.00+$50.00/lot <br /> Owner: Dennis L. Sommerfeld Family Living Trust Buyer: Timothy and Doris Meyer y,� <br /> Address: 2488 Black Brook Road Address: N9427—7301 Street � 3 <br /> Spooner,WI 54801 Colfax,WI 54730 0 <br /> Phone: 715 296-2080 Phone: o <br /> Original Parcel Information c <br /> Parcel ID#:34186 Section 33,Township 39 North,Range 14 West Vi <br /> Original Description(or attach copy): The NW'/a of NE'/,of Section 33,Township 39 North,Rangy 14 p <br /> West,Burnett County,Wisconsin,EXCEPTING therefrom Certified Survey Map#4589 as recorded in <br /> Volume 25,Page 179,as Document#435113. �� o <br /> Current Zoning:A2 Floodplain Y/N: No Wetlands Y No Lake/River Class: N/A o, <br /> Name of Water Body: Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N: Managed Forestry Law Y/N: V' <br /> New Parcel Information ° <br /> Proposed New Legal Description and Parcel Size: The NW'/,of NE'/<of Section 33,Township 39 North, <br /> n <br /> Range 14 West,Burnett County,Wisconsin,EXCEPTING the North 619 feet thereof(which includes <br /> Certified Survey Map#4589,Volume 25,Page 179,as Document#435113 Acres: 19 x <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Easement from Rolling Green Road—Buyers obtained in Deed 4439546 G� <br /> Proposed access to public waters to be provided Y/N: No �1 <br /> If yes,describe access: `( <br /> Signature of Owner: Date: �� — a De�✓� <br /> Signature of Owner: Date: <br /> Fee Rec: <br /> Check#; dI <br /> ➢ Does parcel meet Zoning Requirements? Yes No x <br /> ➢ Does parcel require a Survey? Yes No d° <br /> �z <br /> 0 <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: r � <br /> r z <br /> C C' <br /> Applicati Approved / D ied Reason for Denial: CD { <br /> ro � <br /> c� <br /> n <br /> Date: <br /> Land Use: CD <br />