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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application SuMvislonw/o Survey s50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survev: $200.00+$50.00/lot <br /> Owner: Spencer R. Daniels II Buyer: Chris Wunderlich & Lena Harhai t, <br /> Address: 26176 Heir Road Address: 8010 217 Ave NE S <br /> Webster, WI 54893 Stacy, MN 55079 z <br /> 0 <br /> Phone: 715/566-0094 Phone: 612/598-1279 <br /> Original Parcel Information <br /> Parcel ID#: E�;+1�-Q2 .�Q — - -C <br /> c`+lWL SSU, 016-3413-{)1 410 Section 13 Township 39 Range 17 <br /> W 1/2 SE NE N 1/2 NE SE anthe C <br /> Original Description(or attach copy): � and S 1/2 NE SE, A <br /> Sec. 13-39-17, Burnett County, WI. n <br /> U <br /> n 3�\f ' <br /> Current Zoning: Floodplain/ Y/N: Wetland6 Y/N: Lake/River Class: <br /> VVV 1 <br /> 9 Name of Water Body: l I I��UQ� Shoreland Agreement/SIPS YfN. <br /> Farmland Preservation Y/N: _ Managed Forestry Law Y/N: 5 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size:1. T-lat portico of the SE NE&NE SE, Sec. 13-39-17 <br /> situated S &W of the Clan River, Burnett Cty, WI. 23.9 acres <br /> 2 .SE NE& NE SE Sec. 13-39-17 ocept that situats3'S &W of the Clan River, BLmett Cty, WI <br /> 1JC7Ytim Acres <br /> acres <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Buyer owns parcel to the W abutting Heir Road. p <br /> d <br /> Proposed access to public waters to be provided Y/N: No <br /> 0 <br /> If yes,describe access: <br /> J <br /> Signature of Owner: V` Date: / 0- /5 -/& <br /> O <br /> Signature of Owner: Date: o <br /> ➢ Does parcel meet Zoning Requirements? Yes No d( l p <br /> z <br /> u <br /> ➢ Does parcel require a Survey? Yes No 0 <br /> °O ➢ Permit application fees submitted? ❑ Amount$ Receipt# w s <br /> z _ <br /> wW <br /> r.. -Reconciles with Real Property Lister No Date: 4 :'.(l <br /> y, <br /> CL If not,explain: o 0 0 <br /> 0 <br /> t <br /> a <br /> N <br /> Applicatio Approve / Denied Reason for Denial: <br /> Land Use: Date: w ✓ <br />