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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> and/or Pre-Application Form Subdivision w/o survey: $10.00 <br /> PP Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: David B. and Veronica Fogerty <br /> Address: c/o George W. Benson, Attorney at Law <br /> P.O. Box 370, Siren, WI 54872 <br /> Phone• 715 349-5215 <br /> Ori¢inal Parcel Information ro <br /> 024-3133-O 800 <br /> Parcel Identification#: 024-3133-02 100 Section 33 Township 39N Range 14W 3 <br /> z <br /> Original Description (or attach copy): SW 1/4 NW 1/4, 33-39-14 and <br /> NW 1/4 SW 1/4, 33-39-14 C� <br /> C <br /> J <br /> Current Zoning: t"I * CI'� Floodplain Y/N: Wetlands Y/N: <br /> A <br /> g Lake/River Classification: <br /> Name of Water Body: <br /> New Parcel Information b. <br /> Proposed New Legal Description and Parcel Size: West 30 feet of the South 50 feet of o <br /> the SW NW, 33-39-14; and the West 30 feet o t e - 3 <br /> (Applicant is sellin5E~1�4 } 32-39-14 as well as parcels stated above) <br /> Kemaining parcels: an 3g-1 A <br /> except parcels described above. Acres: 1) <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Greenfield Road <br /> Proposed access to public waters to be provided Y/N: no <br /> d <br /> If yes,describe access: .R' <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N <br /> ➢ Does parcel require a Survey? Yes No n <br /> ao 0 <br /> ➢ Permit application fees submitted? ❑ Amount S-10' LQ / 3 <br /> Receipt# <br /> e <br /> m <br /> a ❑ Reconciles With Real Property ListK Yes. ..-' No Date: o' <br /> ww <br /> If not, explain: = { <br /> o W W <br /> — o <br /> Application: Approve / Denied Reason for Denial: <br /> p G " — Q a <br /> 4 11 b Q Sd c <br /> Land Use: Date: <br /> Z 18/2003 <br />