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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+$50.00/lot <br /> Co—owner <br /> Owner: Donna Chell Kristie Henning <br /> b <br /> et <br /> Address: 23475 County Rd Y Address: 22163 Spirit Lake Rd E i. <br /> Grantsburg, WI 54840 Frederic, WI 54837 ° <br /> Phone: (715)431-0124 Phone: <br /> G <br /> ZA <br /> Original Parcel Information <br /> Tax ID: 23150 <br /> Parcel ID#: PIN: 07-034-2-37-18-02-5 05-002-012000 Section 2 Township 37 Range 18 <br /> 60 <br /> Original Description(or attach copy): Part of Gov't Lot 2 as described in Doc.# 408590 0 <br /> m <br /> a <br /> b <br /> o Current Zoning: RR1 (remainder A2) Floodplain Y/N: Wetlands Y/N: <br /> Lake/River Classification: N 4 Name of Water Body: .•</111/71f Za, __. <br /> f' <br /> Shoreland Agreemt or SIPS Y/N: Farmland Preservation Y/N: Managed Forestry Law Y/N: <br /> New Parcel Information A <br /> Proposed New Legal Description and Parcel Size: Proposed CSM R <br /> ,F <br /> Acres: 0.8 a c ^ <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) a <br /> Proposed access to public road: Spirit Lake Road E v <br /> m <br /> Proposed access to public waters to be provided Y/N: <br /> ki <br /> If ves,describe access: , <br /> 61 <br /> Signature of Owner: I� ,./, 0- b ._//1 Date: 7-027 N <br /> Signature of Owner• el We Dater p , o <br /> a <br /> > Does parcel meet Zoning Requirements? Yes No Cie4277 e* <br /> E. > Does parcel require a Survey? Yes No o <br /> �i� U � y� <br /> rro � / b <br /> Permit application fees submitted? 0 Amount$ i9r RD,p' r# 03 <br /> LCE aVED ch <br /> t, 0 Reconciles with Real Property Lister Yes No Date: G <br /> a <br /> a <br /> If not,explain: JUL 17 2021 <br /> o - <br /> a <br /> Burnett County <br /> Land Services Department <br /> Applicatio • pproved I enied Reason for Denial: <br /> - - i:-a: -- I- 6 <br /> Land Use: I , 9 /r- ZO2/ Date: <br />