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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survev: $200.00+550.00/lot <br /> Owner: Robert W. Andrewson Buyer: Michael R. Hoefs and Aaron D. Hoefs d <br /> Address:24593 County Rd. N Address: 23376 Wood Creek Rd. <br /> z <br /> Webster, WI 54893 Siren, WI 54872 9 <br /> Phone: 715-349-8207 Phone: 612-210-7859 IV <br /> Original Parcel Information CY <br /> ParcellD#: 006-2405-02 500 section 5 Township 38N Range 17W <br /> O <br /> Original Description(or attach copy): NE SE <br /> Current Zoning: F' Floodplain Y/._Wetlancl( /N: Lake/River Class:: <br /> o Name of Water Body: Pr Shoreland Agreement/SIPS YI <br /> 'O <br /> m Farmland Preservation /N: Managed Forestry Law <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Parcel 1 , N 1/2 NA SR, Sar <br /> C, <br /> Parcel 2) S 1/2 NE SE, Sec. 5-38-17 <br /> T <br /> Acres:20 acres each <br /> (if parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: County Rd. N via easements <br /> Proposed access to public waters to be provided Y/N: n/a iJ <br /> If yes,describe access: <br /> C, <br /> Signature of Owner: Date: 30 "'d <br /> Signature of Owner: Date: 3 <br /> e <br /> ➢ Does parcel meet Zoning Requirements? Yes No m <br /> a ` <br /> ➢ Does parcel require a Survey? Yes No <br /> 00 ➢ Permit applicationJees submitted? ❑ Amount S 5_�)' D Receipt# ; <br /> `p,teconciles with Real Property Lister 6Yes. No Date: 9) �1 <br /> 06 If not,explain: <br /> � G <br /> o � <br /> a <br /> H O <br /> Applicati n: Approved enied Reason for Denial: r� / C <br /> Land Use: Date: / '(D /d <br />