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SI;Y-'Ltl-'LUll l;i:'L'I Y.U1/U1 <br /> Fees(muss aceompaw form)' <br /> Burnett County Subdivision Permit Application subdlvlsioa aye survey: $50.00 <br /> and/orPre-A Pre-Application sm�cyoit;wiSuvetmg v: ssu.0onar <br /> �Q Subdivision wl Smvev: 5200.00+t50.001bt <br /> Owner: Larry Lee Hanson Family Trust gayer: Bricker-McKay Family LLC e <br /> c/o Drew Hanson, Trustee c/o Steven 0. McKay, Managing Member <br /> Addresstl6 77 Buccapeer StreetAddress: 79 Norex 1 Av .n r - North <br /> Bokeeelia, FL 33922 Stillwater, MN 55082 0 <br /> c/g15gejjg°SZjW Office w <br /> Phone: Pbone: 651-338-3803 Cell �1 <br /> Original Parcel Information 4__ <br /> J <br /> Parcel iD#: 07-020-2-40-16-10-4 02-000-011OUzuen 10 Township 40 Range 16 <br /> O <br /> Original Description(orattachcopy): Northwest Quarter of Southeast Quarter (NW sa) o <br /> Section 10, Township 40 North, Range 16 West Burnett County Wisconsin . <br /> Current Zoniug: it� I1-3 nFloodplain Y6 WetiandoY/N: Lake/River Class: /Un <br /> Name of Water Body: Shortland Agreement(SIPS YIN: <br /> .. Farmland Preservation Y/N: Managed Forestry Law YIN: <br /> J <br /> New Parcel Information <br /> Proposed New Legal Description and Pared Sim: The North 376 feet of the NWx SE1. <br /> Section 10 Township 40 North Range 16 West Burnett Corr,+„ Hiernnein <br /> Acres: 10.8 <br /> (if parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Otis Road C <br /> Proposed access to public waters to be provided Y/N: NO <br /> s <br /> 0 <br /> If Yea,describe access: <br /> 04 <br /> Signature of Own �— pate. <br /> Drew Ha n, Trustee <br /> SignatureorOwner: Larry Lee Hanson Family Trust Date: <br /> t3 <br /> D Does parcel meet Zoning Requirements? Yes No ),+ <br /> ➢ Does porcel require a Survey? Yes No 0 <br /> sa ;11 <br /> f' Permit applicationfecssubmilted? ❑ Amount Receipt R. <br /> p4 ecaneiles with Real Property Lister Yes No Date: <br /> a If not,explain: o <br /> p <br /> O <br /> Application, Approved / Denied Reason for Denial: <br /> 0 <br /> 0 <br /> C <br />