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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form or Ma Review Form Subdivision w/o Survey: $50.00 <br /> hh h Survey of Existing Parcel: $50.00/lot <br /> Subdivision w/Survev: S200.00+S50.00/lot <br /> Bob Hanson-Dewey Dau, Vince Louwagie <br /> Owner: Buyer: � <br /> Address: 7568 GLENDENING RD Address: <br /> DANBURY Wl 54830 <br /> 715-529-4929 a <br /> Phone: Phone: <br /> Original Parcel Information <br /> 020430502010, 020430502000, <br /> Parcel ID#: 020430502020 & 020430501900 Section 5 Township 40 Range 16 <br /> Original Description(or attach copy): Lots 1 , 2 and Outlot 1 , CSM No. 1808, and Lot 2, <br /> olq <br /> CSM 1156. r"o <br /> RR-1 N/A :A <br /> Current Zoning: Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: <br /> Round Lake <br /> .o Name of Water Body: Shoreland Agreement/SIPS Y/N; <br /> b <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: These three owners have agreed to alter the <br /> lot lines between their properties as accomplished in Deeds recorded as Document Nos. <br /> 459245 and 459247. e out of is eliminated. <br /> Acres 3 s;f -t CD,,.: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Direct access to Glendenning Road <br /> Proposed access to public waters to be provided Y/N: N <br /> If yes,describe access: <br /> Signature of Owner: N/A Date: <br /> argnature of uwner: irate: 3 <br /> b <br /> a <br /> ➢ Does parcel meet Zoning Requirements? Yes No Z Z' <br /> N ➢ Does parcel require a Survev? Yes No <br /> Permit application fees submitted? ❑ Amount$ Receipt# <br /> � 1 <br /> ❑ Reconciles with Real Property Lister Yes No Date: 10 <br /> oIf not,explain: ti <br /> A <br /> 0 <br /> o Applicati Approved / nied Reason for Denial: <br /> Land Use: Z Z ZQ/ Date: <br />