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Fees(nmstacc,;;,.panyfir! •�� <br /> Bu.--nett County Sabdiv.sion Permit .1ipplication Subdivit,io,, t,!�_ urvey: <0.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survev: 5200.00+$50.00/lot <br /> Owner: Carolyn Wedin Buyer: Mark Hulsether <br /> PV <br /> Address: 11080 State Road 48 Address: 1739 West Cliff Drive g <br /> Frederic, WI 54837 Maryville, TN 37803 c <br /> Phone: 715-327-8463 Phone: 865-705-3745 <br /> Original Parcel Information �E <br /> Parcel ID#: 034152603400 Section 26 Township 37N Range 18W <br /> Original Description (or attach copy): Lot 1, CSM 1095, V. 5, p.216-217 <br /> I ' <br /> Current Zoning: RR3 Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: NA <br /> C <br /> Name of Water Body: Shoreland Agreement/SIPS Y/N: N 1 <br /> ., Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> The adjoining property owner (Carolyn Wedin) will deed approximately 1 acre on north side <br /> Of the exisliP9 10t tQ M� Hwisether A ne'A' CSM will merge the additional land with the axistimp� <br /> lot to create a new legal of one parcel. This is exempt from subdivision permit and fees. <br /> Acres: Total —? 5 A <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Existing Frontage on STH 48 C <br /> m <br /> Proposed access to public waters to be provided Y/N: N <br /> If yes, describe access: <br /> Signature of Owner: `�(/' ��� Date: <br /> Signature of Owner: Date: o <br /> b <br /> ➢ Does parcel meet Zoning Requirements? < Yes No per,.�p C S .,t <br /> e <br /> ➢ Does parcel require a Survey? _Yes No <br /> °O ➢ Permit application fees submitted? ❑ Amount S 4m= Receipt# <br /> r, ❑ Reconciles with Real Property Lister Yes No Date: <br /> m <br /> 0 <br /> ° If not,explain: <br /> Apolical n Approved 1 De Ro.won fot Denial: <br /> i <br /> Land <br />