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Burnett County Subdivision Permit Application Fees(must accompany form): Oa <br /> Subdivision w/o Survey: $jk 6 r <br /> and/or Pre-Application Form Subdivision w/Survey:$100.00+$15.00got <br /> V" Diane Decks Estate, Karen Smestad and <br /> Owner:6 Rgar Wagpniuc <br /> NIcolle Decks, PR 22458 Maplewood Rd A <br /> Address: Karon Smcgtarl 99959 Smew-ad Geirr ntghnrg WI 54840 B <br /> Karen: 463-2428 phone: Nicolle: 463-2625 z <br /> 0 <br /> Orieinal Parcel Information Ui <br /> Parcel Identification#: 042-2531-01 900 Section 31 Township 38N Range 18W <br /> Original Description or attach copy): NE 1/4 of the SW 1/4 <br /> 4 <br /> 0 <br /> A <br /> 0 <br /> Current Zoning: (14q7—C✓i a Ol Floodpiain Y/N: N Wetlands Y/N: N A 'p <br /> Name of Water Body: <br /> Lake/River Classification: N N S <br /> P <br /> New Parcel Information <br /> h <br /> Proposed New Legal Description and Parcel Size: 1) NE 1/4 of the SWI/4 except the V <br /> West 825 feet thereof. Acres: 15 2) The West 825 feet of the NE 1/4 of the a <br /> SW 1/4 Acres: 25 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) z <br /> Proposed access to public road: BoHi af antaL- And h,••.. a •_„__. ,__ j «____t_ „ <br /> hAR <br /> Proposed access to public waters to be provided YIN: pl <br /> If yes, describe access: C <br /> m <br /> A <br /> Signature of Owner: Date: <br /> W <br /> ➢ Does parcel meet Zoning Requirements? Yes No p <br /> CKO <br /> Does parcel require a Survey? Yes No <br /> n <br /> D Permit application fees submitted? ❑ Amount$ i t3 Receipt# //619t) 9 <br /> 4 <br /> C <br /> ei/Reconciles with Real Property Lister Yes No Date: <br /> cL Q <br /> If not,explain: {{: <br /> a <br /> [Y.�1 <br /> 1 lull <br /> W <br /> Applicata �Approved enied Reason for Denial: <br /> a <br /> ���✓l� <br /> Land Use Date: c <br /> ell <br /> 0 <br />