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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+$50.00/lot <br /> Owner: Daniel Makosky Buyer: Triple J Boat/Duane Hare <br /> b <br /> fD <br /> Address:4419 State Rd 70 Address: 24850 Big Sand Lake Dr B <br /> Webster WI 54893 Webster WI 54893 <br /> Phone: Phone: 715-566-0759 <br /> C• <br /> Original Parcel Information <br /> Parcel ID#: <br /> 07-026-2-39-15-32-5 05-008-025100,05 008-025200 Section 32 Township 39N Range 15W <br /> Original Description(or attach copy): Lot 4 CSM#3924 V20 P172, Lot 23 CSM#4816 V27 P37 O <br /> a <br /> li <br /> I <br /> 1:1 Current Zoning: RR1 Floodplain Y/N: N Wetlands Y/N: N Lake/River Class: 3 <br /> 3= <br /> ft m Name of Water Body: N/A Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N: N Managed Forestry Law Y/N: N kL <br /> New Parcel Information .."!„, <br /> Proposed New Legal Description and Parcel Size: CSM changing lot lines on . existing parcel 3\ <br /> la <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C <br /> a <br /> Proposed access to public waters to be provided Y/N: <br /> W <br /> If yes,describe access: A <br /> Signature of Owner: ' o`er`, A / '.'i'' Date: eh'5 I7 <br /> 41 <br /> Signature of Owner: ,_._�� 0 , Date: �/i37cc <br /> a <br /> b <br /> D Does parcel meet Zoning Requirements? Yes No C4" <br /> L /�V# Cie 3[79/ eD <br /> C <br /> N 4k <br /> D Does parcel require a Survey? Yes No <br /> E. <br /> a0 > Permit application fees submitted? 0 Amount$ ZSQ O Receipt# W <br /> r, 0 Reconciles with Real Property Lister Yes No Date: 1/4. <br /> ti .11/41a <br /> 0 <br /> a. If not,explain:es <br /> o �' <br /> Application: pproved / enied Reason for Denial: <br /> Land Use: - <br /> Date: ©ZZ <br /> O / <br /> / <br />