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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: $SO.00Aot <br /> and/or Pre-Application Form Subdivision w/Survev: $200.00+$50.00/lot <br /> John H. Taylor and <br /> Owner:Constance J. Taylor Buyer: St_ Croix Chipppwa Tnrlianc of y <br /> Wisconsin 3 <br /> Address: 5960 State Road 70 Address: p 0 Roti 347 <br /> Webster, WI 54893 Hertel , WI 54845 z <br /> 0 <br /> Phone: <br /> (715) 349-2569 Phone: (715) 349-7505 <br /> Orieinal Parcel Information Y <br /> 07-018-2-39-16-36-3 03-000-011000 <br /> Parcel ID#: Section -AF; Township Soni Range trw_ O <br /> 0 <br /> Ori inalDescrietion(orattach coppy): The Southwest Quarter of the Southwest Quarter ; <br /> of ection p36, township 39oN rtF, ange 16 West. <br /> � p 1 <br /> e T <br /> C <br /> m <br /> Current Zoning: unzoned Floodplain YIN: N Wetlands YIN: Ni�j <br /> Lake/River Classification: N/A Name of Water Body: Ni lA <br /> _d <br /> New Parcel Information <br /> Parcel will be divided into the West 25 <br /> Proposed New Legal Description and Parcel Size: acras of UP &W 914, 36-39-16 <br /> parcel described as the SW SW, 36-39-16 excepting therefrom the West 25 acres <br /> that will remain in the ownership of sellers & descrAi �i as SE SW, 36-39-16. <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: see attached <br /> tD <br /> Proposed access to public waters to be provided YIN: N A <br /> If yes,describe access: d <br /> oN Signature of Owner: Date:_ <br /> o John H. Taylor <br /> Signature of Owner: r Date: 2 <br /> 9 <br /> ➢ Does parcel meet Zoning Requirements? Yes No A <br /> e ➢ Does parcel require a Survey? Yes No p <br /> a 0� <br /> Permit application fees submitted? Amount$ LIM Receipt# <br /> o W <br /> w Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> v <br /> Applicati : Approved / Denied Reason for Denial: NAV I <br /> 4z U L T <br /> Land Use: Date: BURNETT COU <br /> //)L-I), ING <br />