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Burnett County Subdivision Permit Application <br />Fees (must accompany form): <br />and/or Pre -Application Form or Ma Review Form <br />pp p <br />Subdivision w/o Survey: $50.00 <br />Survey of Existing Parcel: $50.00/lot <br />Subdivision w/ Survev: %200.00 +.S50-00/lot <br />Paul & Dawnette Marty <br />Owner: Buyer: <br />Address: 29993 MINERVA DAM RD Address: <br />DANBURY WI 54830-9716 <br />Phone: 612-282-7306 <br />Phone: <br />Original Parcel Information <br />Parcel ID #: 032533501700 Section 35 Township 41 Range 16 <br />Original Description (or attach copy): Lot 2, Outlots 1 and 2, CSM No. 1720, <br />V.9, p. 113-114, including part of Lot 1 of Plat of Big Sky, located in <br />NWY4-NE'/4 and NE'/4-NE'/4. <br />Current Zoning: RR -2 Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: N/A <br />Name of Water Body: Minerva Flowage Shoreland Agreement/SIPS Y/N: N <br />Farmland Preservation Y/N: N Managed Forestry Law Y/N: <br />New Parcel Information <br />Proposed New Legal Description and Parcel Size: We are submitting a new CSM that <br />merges these three parcels into one lot. <br />Acres: 0.72± <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: Direct access Minerva Dam Road. <br />Proposed access to public waters to be provided Y/N: N <br />If yes, describe access: <br />Signature of Owner: N/A Date: <br />,Nignature of uwner: mate: <br />➢ Does parcel meet Zoning Requirements? Yes No <br />�GL <br />➢ Does parcel require a Survey? Yes No <br />Permit application fees submitted? ❑ Amount $ <br />5, V' <br />❑ Reconciles with Real Property Lister Yes No Date: <br />If not, explain: <br />Application: <br />Land Use: <br />Vy1B� <br />Reason for Denial: <br />Receipt # <br />4 <br />S <br />44- <br />t <br />