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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 or Map Review Form Subdivision w/Survev: 8200.00+$50.00/lot <br /> Owner: Arvid L.Harmon Buyer: Terry D. &Lucille M.Berger Q <br /> Address: 26265 County Road F Address: 26251 County Road F Lei <br /> Grantsburg,WI 54840 Grantsburg,WI 54840 C\J <br /> Phone: (715)4611-2555 Phone: (715)463-2377 <br /> 0 <br /> Original Parcel Information <br /> Parcel ID#: 07-040-2-39-19-14-204-000-011000 Section 14 Township 39N Range 19W <br /> Original Description(or attach copy): SE NW EX E 660'of S 462'.N 330'of S 990' EX E 660'.S 330'of N <br /> 660'of E 660' <br /> Current Zoning: 1G=t/G-6_ Floodplain Y/N: N Wetlands YIN: N Lake/River Class: N/A <br /> Name of Water Body: N/A Shoreland Agreement/SIPS YIN: N/A <br /> t <br /> 'o <br /> Farmland Preservation YIN: N Managed Forestry Law Y/N: N <br /> d <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: See Addendum"A" <br /> t7 <br /> Acres: 3 ee <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> c� <br /> Proposed access to public road: County Road F <br /> Proposed access to public waters to be provided Y/N: N/A <br /> 'b <br /> If yes,describe access: <br /> Signature of Owner: cll"Lr� wy»,o ar Date: 0 ff r5 -7 1 .s <br /> Signature of Owner: Date: <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N ➢ Does parcel require a Survey? Yes No <br /> ➢ Permit application fees submitted? Amount$ Receipt# SU <br /> ` a (Z <br /> 1TReconciles with Real Property Lister Yes No Date: , <br /> m .r G <br /> � If not,explain: <br /> a <br /> d <br /> o <br /> y <br /> Application- Approved enied Reason for Denial: <br /> Land Use: Q /O ZO/s Date: AUb 10 7 <br /> RURNET-r r o l INN <br /> ZONING <br />