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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-A lication Form Subdivision w/o Survey: $10.00 <br /> PP Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: Larry and Lynn PETERSON <br /> Address: c/o George W. Benson, Attorney at Law <br /> P.O. Box 370, Siren, WI 54872 Phone: 715 349-5215 <br /> Original Parcel Information ro <br /> A <br /> Parcel Identification#• 006-2413-01 900 Section 13 Township 38N Range 17W 3 <br /> 2 <br /> Original Description (or attach copy): NW NW except highway % <br /> Current Zoning: mfg 6 acres Floodplain Y/N: n Wetlands Y/N: n O <br /> t'— Lake/River Classification: n/a <br /> Name of Water Body: <br /> e <br /> -S <br /> New Parcel Information <br /> 4- <br /> Proposed <br /> Proposed New Legal Description and Parcel Size: The NW 1/4 NW 1/4, Section 13, t <br /> _Township 38 North, Range 17 West, lyinq Northerly and Westerly of State Highway <br /> 70 and lvinc Southerly and Westerly of Daniels 70 Acres: 6.38 <br /> fi <br /> (If parcel is to be surveyed,provide preliminary map. See attached for map requirements.) <br /> a <br /> Proposed access to public road: Daniels 70 <br /> Proposed access to public waters to be provided Y/N: n/a C <br /> m <br /> If yes,describe access: g <br /> V <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> ➢ Does parcel require a Survey? Yes No n ' <br /> e o <br /> 00 3 <br /> ➢ Permit application fees submitted? ❑ Amount$ Receipt# <br /> A <br /> 'c <br /> ❑ Reconciles With Real Property List(rYes No Date: o <br /> a o <br /> If not,explain: <br /> o � <br /> W <br /> Applicatio �Approved enied Reason for Denial: a <br /> 0 <br /> a <br /> Land Use Date: <br /> 2/18/2003 <br />