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Burnett County Subdivision Permit Application Fees(must wcompmyform): <br /> Subdivision w/o Survey: SI0.00 <br /> and/or Pre-Application Form Subdivisio W/Survey:$100.00+sI5.00n0t <br /> Owner: Donald E./Dorothy A. Brenizer <br /> Address: 23345 S. Williams Rd. <br /> Grantsburg , WI 54840 Phone: 463-5762 <br /> OrieinalParcel Information Lu000 QI(J 8 <br /> Parcel Identification#: 042-2519-02 500 Section 19 Township 38 Range 18 P <br /> Original Description(or attach copy): N E; SE <br /> O <br /> F <br /> V <br /> w Current Zoning: NFloodplain Y/N: N Wetlands Y/N: N <br /> Lake/River Classification: _ N/A Name of Water Body: N/A v� <br /> New Parcel Information <br /> 1 <br /> Proposed New Legal Description and Parcel Size: 1 ) NE; SE, , Section 19-38-18 , <br /> excepting the North 372 feet thereof (29 Acres) . 2 . The North <br /> 372 feet of the NE; SE; , Sec . 19-38-18 (11 Acres)lcres• <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: S. Williams Road <br /> 0 <br /> Proposed access to public waters to be provided Y/N: N e <br /> If yes,describe access: <br /> J <br /> O <br /> Does parcel meet Zoning Requirements? Yes No O'1 <br /> ➢ Does parcel require a Survey? Yes No g <br /> ea <br /> A o <br /> Permit application fees submitted? ❑ Amount b Receipt# <br /> Mt <br /> ❑ Reconciles With Real Property ListerYes No Date: <br /> a <br /> If not,explain: ) <br /> 1 <br /> P <br /> Applicatio Approve / Denied Reason for Denial: qJ <br /> Land Use: <br /> Date: / <br /> vletz003 <br />