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Fees(must accompany form): <br /> Burnett County Subdivision Permit Application Subdivision w/o Survey: $50.00 <br /> and/or Pre-Application Form Subdivsionrvey of w Survey: <br /> $: 0.00+$t <br /> Subdivision�v/Survey: $200.00+$j0.00/lot <br /> Owner: Russell Helland Buyer: <br /> Address: 29809 Cranberry Lake Dr Address: g <br /> Danbury WI 54830 0 <br /> Phone: Phone: <br /> Original Parcel Information I <br /> Parcel ID#: 07-032-2-41-16-35-5 05-002-018000 Section 35 Township 41N Range 16W <br /> Original Description(or attach copy): Lot 3 & PCL Lot 1 <br /> g <br /> n <br /> II <br /> ›- <br /> "a <br /> .a Current Zoning: RR2 Floodplain YN: Y Wetlands Y/N: N Lake/River Class: <br /> ^u <br /> Name of Water Body: Minerva Lake&Minerva Dam Flowage Shoreland Agreement/SIPS YN: N <br /> Farmland Preservation YIN: N Managed Forestry Law UN: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM <br /> Acres: 0.52 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C7 <br /> n <br /> Proposed access to public waters to be provided YN: CD <br /> If yes, describe access: <br /> Signature of Owner: __A Date: ij <br /> OI <br /> Signature of Owner: Date: o <br /> ^c <br /> > Does parcel meet Zoning Requirements? Yes No ° <br /> N <br /> a > Does parcel require a Survey? Yes No <br /> F t9d <br /> °° > Permit application fees submitted? ❑ Amount$ ,...S29,i � Receipt# W <br /> 5Reconciles with Real Property Lister es No Date: 6/8/a)41 rz <br /> / /ate <br /> a <br /> r, <br /> If not,explain: <br /> n <br /> n <br /> 0 <br /> Applicatio.. Approved / I• ied Reason for Denial: <br /> Land Use: �.."C p /9,292- ate: <br />