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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form or Map Review Form Subdivision w/o Survey: $50.00 <br /> Survey of Existing Parcel: $50.00/lot <br /> Subdivision w/Survey: $200.00+$50.00/lot <br /> Owner: MARGARET CASHMAN Buyer: <br /> PO BOX 313 g <br /> Address: DANBURY WI 5483 Address: <br /> P <br /> 715-656-3499 G' <br /> ta <br /> Phone: Phone: <br /> Original Parcel Information 7 <br /> Parcel ID#: 032521701400 Section ' Township 4 Range 15 40 <br /> a <br /> Original Description (or attach copy): Parcel Described in Deed Document No. 353549 n <br /> 3 <br /> Current Zoning: RR-3 Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: /A <br /> .a Name of Water Body: Unnamed Pond Shoreland Agreement/SIPS Y/N: N <br /> a Farmland Preservation Y/N: N Managed Forestry Law Y/N: <br /> a <br /> New Parcel Information 3 <br /> Proposed New Legal Description and Parcel Size: We are submitting a CSM of <br /> an existing parcel. <br /> Acres: 4.96 A <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Direct access to Staples Lake Road and STH 77. o <br /> to <br /> Proposed access to public waters to be provided Y/N: N �� <br /> If yes,describe access: pti <br /> Signature of Owner: N/A Date: <br /> (-5 <br /> signature of owner: Date: ° <br /> 9 <br /> b <br /> = <br /> ). Does parcel meet Zoning Requirements? Yes Nocje, ft /j1�� fD <br /> ➢ Does parcel require a Survey? Yes No ib <br /> o <br /> cm <br /> '5* > Permit application fees submitted? ❑ Amount$ 50,t2,1?-2-.- Receipt# <br /> 0 Reconciles with Real Property Lister Yes No Date: k) <br /> eIf not,explain: W <br /> o. 00 <br /> 7� d <br /> n <br /> n <br /> 0 <br /> o. Application: •pprove I Denied Reason for Denial: <br /> Land Use: fjP, // 3 749 Zp Date: <br /> / <br />