Laserfiche WebLink
Fees (must accompany fomi): <br />Burnett County Subdivision Permit Application Subdivisionw/oSurvey: $50.00 <br />Survey of Existing Parcel: $50.00/lot <br />and/or Pre -Application Form Subdivision w/ Survev: $200.00+$50.00/lot <br />Owner: ML Holst LLC Buyer: <br />Address: 852 138th St Address: <br />Amery, WI 54001 <br />0 <br />715-821-2150 <br />Phone: Phone: <br />Original Parcel Information <br />t <br />Parcel ID #: 07-040-2-39-19-27-3 03-000-011100 Section 27 Township39N Range 19W <br />Original Description (or attach copy): _SW SW Ex W 450' of the S 484' <br />3 <br />r <br />Current Zoning: RR3 Floodplain Y/N: ___N_Wetlands YIN: N Lake/Myer Class: - <br />Name of Water Body: NIA Shoreland Agreement/SIPS Y/N: N/A� <br />Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br />New Parcel Information <br />Proposed New Legal Description and Parcel Size: New 1 Lot CSM Existing Parcel <br />Acres: 35.0 <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: <br />G <br />Proposed access to public waters to be provided YIN: <br />If yes, describe access: <br />Signature of Owner: ,MM�-- l�l�` . --- Date: 3/26/2019 <br />Signature of Owner: Date: c <br />Does parcel meet Zoning Requirements? Yes No <br />-s <br />N <br />Does parcel require a Survey? Yes No <br />Permit application fees submitted? ❑ Amount S Receipt # <br />t ❑ Reconciles with Real Property Lister Yes No Date: <br />If not, explain: �L ( .3 $tRD; <br />Lij <br />r <br />O <br />Applicati Approved /monied Reason for Denial: <br />Land Use <br />2©�/ Date: <br />Services Department <br />