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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> • <br /> Survey of Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: GM Danbury LLC -Greg Wade Buyer: Brandon Hackett ,0 <br /> A <br /> Address:29597 Pardun RdAddress: 7972 63rd St S g. <br /> Danbury WI 54830 Cottage Grove MN 55016 0 <br /> Phone: Phone: 715-566-3414 <br /> Original Parcel Information <br /> Parcel ID#: 07-032-2-41-16-28-1 04-000-013100 Section 28 Township 41 N Range 16W <br /> Lot 1 CSM V26 P1 (SE NE) <br /> Original Description(or attach copy): a <br /> ZY <br /> .o Current Zoning: Cl Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: <br /> aName of Water Body: Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N:N Managed Forestry Law Y/N: N <br /> New Parcel Information r` <br /> Approx 300' parcel SE corner of lot 2+/- acres <br /> Proposed New Legal Description and Parcel Size.. <br /> Acres:2.07 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: d <br /> a <br /> A <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: <br /> `�� // <br /> Signature of Owner: Anz-G (A) F Date: - /3 �d <br /> Signature of Owner: Date: o <br /> 14 <br /> Tsp = <br /> > Does parcel meet Zoning Requirements? Yes No 3 i Q' o <br /> N <br /> )=. Does parcel require a Survey? Yes No 0/ <br /> r7 <br /> o <br /> °Q ➢ Permit application ffees submitted? 0 Amount$ Receipt# <br /> r"' 0 Reconciles with Real Property Lister Yes No Date: <br /> a <br /> a <br /> °' If not,explain: <br /> 7? <br /> 0 <br /> -s <br /> 0. <br /> rn <br /> Applicatio 1: Approved I enied Reason for Denial: <br /> Land Use://r-a' ���0e0a Date: <br />