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Nees(must accompany torn): <br /> Burnett County Subdivision Permit Applic n Subdivisionw/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survev: 5200.00+$50.00/lot <br /> Owner: _.Judith A_ Fnntp Buyer: <br /> A <br /> Address: P.O.Box 504 Address: B <br /> z <br /> Webster, WI 54893 <br /> W <br /> Phone: 715-866-7574 Phone: W <br /> -C <br /> Orieinal Parcel Information J <br /> 000-011000 <br /> Parcel ID#: 07-020-2-40-16-28-3 01- Section 28L Township anN Range 1 Fw O <br /> e <br /> Original Description(or attach copy): The Northeast Quarter of the Snuthwpct nuartpr <br /> (NEA SWA) of Section Twenty-eight (22) Tnwnchin Fnrty (40) North, <br /> Range Sixteen, (16) West, Burnett County. Wisconsin- <br /> 0 <br /> Current Zoning: A-2 Floodplain YIN: N Wetlands YIN: N <br /> Lake/River Classification: n/a Name of Water Body: n/a <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Sep attached npceriptinn <br /> ach �ar� el will <br /> Acres: nnro acres a pr <br /> Sa civision <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Each parcel would have approximately 330 feet of <br /> frontage on County Road C. d <br /> Proposed access to public waters to be provided Y/N: M g <br /> If yes,describe access: so <br /> ri <br /> O -� <br /> vN Signature of Owner: Date: /2--$-6 <br /> O <br /> 6 <br /> 00 Signature of Owner: Date: 0 <br /> V <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> o ➢ Does parcel require a Survey? Yes No T <br /> a <br /> Permit a kcation ees submitted? ❑ Amount$Jr�' O U �"� Al <br /> m pp f Receipt# o <br /> C t <br /> CL ❑Reconciles with Real Property Lister 4Yel No Date: v l <br /> If not,explain: �0 <br /> Q <br /> C <br /> Applicati Approved / enied Reason for Denial: d <br /> Land Use: Date: <br />