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Fccs(must accompany form): <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 Subdivision w/Survey: S200.00+$50.00/lot <br /> Owner: GM Danbury LLC - Greg Wade Buyer: Brandon Hackett <br /> Address:29597 Pardun Rd Address: 7972 63rd St Sg. <br /> Danbury WI 54830 Cottage Grove MN 55016 <br /> Phone: Phone: 715-566-3414 <br /> Original Parcel Information <br /> Parcel ID#: 07-032-2-41-16-28-1 04-000-013100 Section 28 Townshi4p 1 N Range 16W <br /> O <br /> Original Description(or attach copy): <br /> Lot 1 CSM V26 P1 (SE NE) <br /> Current Zoning: Cl Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: <br /> Name of Water Body: Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Approx 300' parcel SE corner of lot 2+/- acres <br /> Acres:2.07 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> a <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: `/ <br /> Signature of Owner: 34err' Y�"G. 2, Date: 3/11/2020 <br /> Signature of Owner: Date: <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> ➢ Does parcel require a Survey? Yes No <br /> E. <br /> rro <br /> Permit application fees submitted? 0 Amount$ Receipt# <br /> 0 Reconciles with Real Property Lister Yes No Date: <br /> a <br /> a <br /> If not,explain: <br /> c. <br /> Application: Approved / Denied Reason for Denial: <br /> Land Use: Date: <br />