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Fees(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: $200.00+$50.00/lot <br /> Owner: Daniel Milligan Buyer: Brian Hinrichs <br /> et <br /> Address: 11980 State Rd 48 Address: 14686 State Rd 70 i. <br /> Grantsburg, WI 54840 Grantsburg, WI 54840 ° <br /> C <br /> Phone: 715-488-2417 Phone: 715-220-1982 a' <br /> Original Parcel Information t <br /> Parcel ID#: 07-010-2-38-19-17-4 04-000-013000 (Tax ID:4230) Section 17 Township 38 Range 19 r <br /> O <br /> Original Description(or attach copy): 0 <br /> SE SE EX W 330' & EX E 330' (EX HWY #163144) nY r <br /> .. <br /> ' <br /> oCurrent Zoning: A2 Floodplain Y/N: Wetlands Y/N: Rs <br /> Lake/River Classification: Name of Water Body: <br /> Shoreland Agreemt or SIPS Y/N: Farmland Preservation Y/N: Managed Forestry Law Y/N: <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Proposed CSM <br /> (Prepared only for transfer between adjacent owners) t. <br /> Acres: 1.6± <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) 3 <br /> Proposed access to public road: State Road 70 0 <br /> m <br /> Proposed access to public waters to be provided Y/N: �� <br /> �i\ <br /> If yes,describe access: 11 <br /> Signature of Owner:\r A 4 :,,.' ,-k--, k'_ �_ ) Date: ,t, +---S <br /> Signature of Owner: Date: 3 <br /> b <br /> CA. e <br /> Does parcel meet Zoning Requirements. Yes No et <br /> N -1 <br /> o ch- <br /> E. ➢ Does parcel require a Survey? Yes No ,/f0 R04 <br /> crQ <br /> oo a/PaoPermit application fees submitted? 0 Amount$ �i Receipt# <br /> r ® Reconciles with Real Property Lister es No Date: d.l tri la% <br /> 0 <br /> 0. <br /> r If not,explain: <br /> n <br /> 0 <br /> K <br /> a <br /> Application. , pproved I enied Reason for Denial: <br /> Land Use: "2- ZOLf Date: <br />