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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'. $50.0011ot <br /> and/or Pre-Application Form Subdivision wi Survev: %200.00 4 $50 00/101 <br /> Owner: Virginia Kay Harder Rowe Buyer: Cliffhangers of Minnesota, Inc. <br /> m <br /> Address: 10905 get ExtPrigion Address: c/o Ted Priem <br /> Cable, WI 54821 1105 Pine Street o <br /> roix Falls, WI 54024 <br /> Phone: 715-798-4046 Phone: 239-693-5895 <br /> Original Parcel Information <br /> Parcel ID#:07-024-2-39-14-03-4 01-000-01100gection 3 Township 39N Range 14W <br /> O <br /> Original Description(or attach copy): NEI/4 of SE1/4 Section 3. Township "19 North <br /> n <br /> Range 14 West <br /> .p Current Zoningl. Floodplain YIN: N Wetlands YIN: N Lake/River Class: N <br /> m Name of Water Body: None Shoreland Agreement/SIPS 1'/N: N <br /> Farmland Preservation YM: N Managed Forestry Law Y/N_ N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: North 20 acres (Nl/2 of NE1 /4 of S .1 /4 ) <br /> 5 <br /> to be retained by owner, Virginia Kay Harder Rowe. South 20 acres (Sl/2 <br /> NE1/4 of SE1/4) to be sold to Cliffhangers of Acres: <br /> Minnesota, Inc. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: None. Access to be by easement from owners of d <br /> land to South. A <br /> Proposed access to public waters to be provided Y/N: N <br /> If yes,describe access: (� <br /> ,/ v <br /> Signature of Owner. � 111 'lt.tw Y1rw "-,��,:� Date: <br /> L <br /> Signature of Owner: Date: o�p <br /> �-3 <br /> c � <br /> Does parcel meet Zoning Requirements? No <br /> to?Pr <br /> y ➢ Does parcel require a Survey? )es <br /> SL N <br /> °Q ➢ Permit application fees submitted? ❑/ Amount$ 5 b' (D o Receipt:is <br /> r• econciles with Real Property Lister Yes i No Date: t', W ray <br /> It not,explain: — ' <br /> e N <br /> 0 <br /> Application. Arow / Denied Reason for Denial: <br /> G <br /> / d <br /> Land Use: Date: ✓! �✓ _— <br /> v <br />