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Burnett County Subdivision Permit Application <br />and/or Pre -Application Form <br />Duane V. & Cheryl L. Johnson <br />I -] owner: Gary S. & Jane C. Bell <br />Address: 12304 County Rd. D. <br />Grantsburg, WI. 54840 <br />Fees (must accompany form): <br />Subdivision w/o Survey: $10.00 <br />Subdivision w/ Survey:S 100.00 + $15.00/lot <br />Phone: 715-463-2750 <br />Original Parcel Information <br />Parcel Identification #: 042-2505-02 700 Section 5 Township 38 Range 18 <br />Original Description (or attach copy): SE SW EX South 900 feet thereof. <br />Current Zoning: <br />Lake/River Classification: <br />Floodplain Y/N: Wetlands Y/N: <br />Name of Water Body: <br />New Parcel Information ` 1 <br />Proposed New Leal Description and Parcel Size: SE SW EX South 900 feet thereof <br />and also EX that portion of the SE Sw, Sec. 8-18 <br />included in Lot 1, CSM No. 3860 recorded in Vol. 20, pages 26 & 27 <br />as Doc. #Jbb894 and being oca a in the ec. <br />Township 38 North, of Range 18 West, Burnett Acres: <br />County, WI. *See adden um or urt er anguage for deed <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: access through property already owned by <br />Owners. <br />Proposed access to public waters to be provided Y/N: <br />If yes, describe access: <br />➢ Does parcel meet Zoning Requirements? Yes No <br />➢ Does parcel require a Survey? Yes No <br />➢ Permit application fees submitted? O Amount $ Receipt # <br />❑ Reconciles With Real Property Lister Yes No Date: <br />Application: Approved / Denied Reason for Denial: <br />b <br />A <br />a <br />z <br />0 <br />C <br />A <br />Land Use: <br />2/18/2003 <br />Date: <br />