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r•ees(must accompany Corm): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: 550.00/lot <br /> and/or Pre-Application Form Subdivision w/Survey. 6200.00+550.00not <br /> Owner: Gloria J. Weaver Buyer: Son J. Weaver and Misty S. Weaver <br /> ro <br /> Address: 3018 County Road A Address: 2996 Augustine Road 6 <br /> Webster. WI 54893 Webster, WI 54893 z <br /> 0 <br /> Phone: (715) 635- 2693 Phone: (715) 635- 7948 <br /> Oripinal Parcel Information <br /> Parcel ID#: 028-4119-03 200 Section 19 Township 40 Range 14 <br /> Original Description(or attach copy): all that part of Gov. Lot 5 lying N & W of <br /> County Trunk A, except ....... (see attached map) <br /> o <br /> e _ ! <br /> Current Zoning: Y/� <br /> , / Floodplain : Wetlands Y/N: <br /> Lake/River Classification: /V! Name of Water Body: <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: — see attached map and legal description <br /> Owner to keep new 10.14 acre new parcel . Remaining parcel to be transferred <br /> to Jon J. and Misty S. Weaver. Acres: 10.14 acres <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: County Road A <br /> Proposed access to public waters to be provided Y/N: N <br /> A <br /> If yes,describe access: C. <br /> Si Signature of Owner: & d �P C 1 e Date: 9_ 4/4 Va 'G <br /> e Gloria J. Weaver D�L <br /> 00 Signature of Owner: Date: e <br /> B <br /> v <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> e ➢ Does parcel require a Survey? Yes No <br /> a ) <br /> Permit application fees submitted? ElAmount$ (_15Z � 6o Receipt# //L <br /> L <br /> 0 <br /> C <br /> CL <br /> ❑ Reconciles with Real Property Lister ! Yes No Date: .� <br /> If not,eapla�in: o��, (�9[\D \9 �.4�=Qf�Q A ( yyLa�,n ,x�l�t <br /> 'k n : CkIl-A qYI13 � Ga <br /> 0 <br /> Applica on: A r enied Reason for Denial: O <br /> Land Use: Date: <br />