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Fees (must accompany forni): <br />Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br />Survey of Existing Parcel: $50.00/lot <br />and/or Pre -Application Form Subdivisionw/Survev: $200.00+$50.00/lot <br />Owner: Marshall & Judy Hill Buyer: <br />Address: 30275 N Second Ave Address: <br />W.C. King Properties, LLC <br />PO Box 366 <br />Danbury, WI 54830 Webster, WI 54893 <br />Phone: 715-590-3242 Phone: 715-866-7335 <br />Original Parcel Information <br />07-032-2-41-16-28-1 04-000-024000 <br />07-032-2-41-16-23-1 04-000-021000 <br />Parcel ID #: 07-032-2-4 1 -1 6-28-1 <br />7032-2-41-16-28-1 04-000-023000 Section 28 Township 41 N Range 16W <br />Original Description (or attach copy): PCL SE NE Desc 504/162, Lot 1 CSM V2 P55, <br />That Prt SE NE Desc V 254 P259 (RR Spm), & Outlot 1 CSM V26 P246 ISP -,r, in <br />Vol 307 Pg 580 (no PID available). <br />Current Zoning: C1 Floodplain Y/N: N Wetlands YN: N Lake/River Class: - <br />Name of Nater Body: n/a 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 combining Lot 1 CSM V2 P55, Outlot <br />Outlot 1 CSM V26 P246, part of That Prt SE NE Desc V 254 P 259, and part of PCL SE NE <br />Desc 504/162 Acres: 1.85 (+/-) <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: Existing <br />Proposed access to public waters to be provided YN: N <br />If yes, describe access: <br />'. - - _-Z <br />�S <br />H <br />Signature of Owner: <br />Date: I L <br />Signature of Own �rM(�Jh �, <br />Date: <br />➢ Does parcel meet Zoning Requirements? <br />Yes <br />No � <br />LG 1/-7/)9 ,kb, hi, <br />c <br />➢ Does parcel require a Survey? <br />Yes <br />No <br />OQ <br />�U <br />i Permit application fees submitted? ❑ <br />Amount $ <br />Receipt # <br />C. <br />❑ Reconciles with Real Property Lister <br />Yes No <br />Date: <br />If not, explain: <br />0 <br />c <br />Applicatio Approved Denied Reason for Denial: <br />Land Use: 9 <br />�� / <br />Date: <br />�S <br />H <br />