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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:$100.00+$1monot <br /> Owner: Rurick R. & Frances Mattson <br /> Address: 11295 Mattson Rd. <br /> 8 <br /> Luck, WI 54853 Phone: 715/327-8264 Z <br /> 0 <br /> Orieinal Parcel Information <br /> 034-1535-01 600 and <br /> Parcel Identification#: 034-1535-01 700 Section 35 Township 37 Range18 W <br /> Original Description(or attach copy): 1) NEI, NWS J <br /> 2 ) Parcel in NW; NW4 , described as follows: Commencing at the p <br /> E <br /> Southeast corner , thence N. 80 rods , thence W. 80 rods , thence S. <br /> Ltotho Point of h g ' ng � <br /> vnP — <br /> q Current Zoning: a AC Floodplain Y/N: N Wetlands Y/N: N <br /> n <br /> oLake/River Classification: NA Name of Water Body: NA <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: ( See legal attached) <br /> Acres: 37 <br /> 7 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: via Mattson Road <br /> Proposed access to public waters to be provided Y/N: N <br /> If yes,describe access: o <br /> m <br /> submitted y Q <br /> Signature of Owner: J1, ti Date -QZ (? <br /> Ufa QJ <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> J <br /> ➢ Does parcel require a Survey? Yes No <br /> Permit applicationfees submitted? ❑ Amount$ lb, 00 Recei t#"/ 9 <br /> 4 <br /> e <br /> r <br /> � ❑ Reconciles with Real Property Lister Yes,...- No Date: <br /> a <br /> o• C <br /> If not,explain: \nn n A o d :1�jd =moo p&0 OU-OCA162 �A A—zo � s <br /> a �, <br /> w <br /> W (N <br /> U <br /> � I <br /> O o <br /> Application: pproved / enied Reason for Denial: J <br /> d � <br /> Land Use Date: �d <br />