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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Stibdivision w/o Survey $50.00 <br /> Survey of Fxisting Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision w/Survey: $200.00+$50.00/lot <br /> b <br /> Owner: Erickson Commercial LLC Buyer: <br /> v Address:PO Box 614 Address: o <br /> Webster WI 54893 -D <br /> N <br /> Phone: Phone: Y' <br /> Original Parcel Information <br /> Tax ID#: 5828 Section 29 Township 40 Range 15 <br /> Original Description(or attach copy):NE-NE <br /> tz <br /> Current Zoning: RR2 Floodplain Y/N.;-N-- Wetlands Y/N: N Lake/River Class: <br /> Name of Water Body: Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N:N Managed Forestry Law Y/N: N <br /> 0 <br /> New Parcel Information cc <br /> Proposed New Legal Description and Parcel Sizc^ .c <br /> Acres- <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirement&) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: p <br /> Signature of Own er• Date: '" o26 <br /> Signature of Owner: Date: <br /> ➢ Does parcel meet Zoning Requirements? Yes No Fee Rec: Q i� <br /> Check#: �o/Z3© <br /> ➢ Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> Application Approved / 'ed Reason for Denial- <br /> Land Use: Date: <br />