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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form or Map Review Form Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> Subdivision w/Survev: $200.00+$50.00/lot <br /> Don Barnhart - Barnhart Unlimited LLC <br /> Owner: Buyer: <br /> Address: 13729 S. St. Croix Road Address: <br /> Gordon, WI 54838 z <br /> (ir <br /> 218-721-2464 <br /> Phone: Phone: � <br /> Original Parcel Information 6 <br /> W <br /> Parcel ID#: 032 5328 02700 Section 28 Township 41 Range 16 C <br /> Original Description(or attach copy): Parcels described in Doc. Nos. 395999 & 436372 <br /> in the SE'/4-SW%, Section 28, Township 41 N, Range 16W. <br /> 0 <br /> Current Zoning: C-1 Floodplain Y/N:--U—Wetlands Y/N: N Lake/River Class: <br /> 1 <br /> o Name of Water Body: Shoreland Agreement/SIPS Y/N: N <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N W <br /> .. New Parcel Information V, aa <br /> Proposed New Legal Description and Parcel Size: This is a CSM of an existing parcel. <br /> furthermore, we resolved a gap in title and merged the gap into this parcel. <br /> Acres: 1 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: -,ng Direct Access to STH 77 & 35. <br /> Proposed access to public waters to be provided Y/N: N <br /> If yes,describe access: <br /> Signature of Owner: N / A Date: <br /> n <br /> btgnature of uwner: nate: - <br /> -o <br /> c <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> x <br /> ti <br /> ➢ Does parcel require a Survey? Yes No <br /> a.� <br /> 5' ➢ Permit application fees submitted? ❑ Amount$ ,���� Receipt# <br /> T: <br /> ❑ Reconciles with Real Property Lister Yes No Date: <br /> L If not,explain: <br /> o, <br /> z <br /> n <br /> O <br /> a Application pproved / enied Reason for Denial: L 2 2016 <br /> N <br /> Land Use: 1 �, 8 z�/� Date: <br /> ZONING <br />