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Fees(must accompany limn): <br /> Subdivision w/o Survey: S50.00 <br /> Burnett County Subdivision Permit Application Survey fiir Existing Parcel: $50.00/lot <br /> and/or Pre-Application Form or Map Review Form Subdivision n/Survey:x200.00 $50.00nnt <br /> Owner: Pavlak Revocable Trust dated May 6,2013 Buyer: Randy Wheaton and Dawn Wheaton _ _ <br /> Jessica Pavlak,Trustee Address: 8727 Immanuel Road <br /> Address: 6671 Folsom Path, Farmington,MN 55024 Yorkville, IL 60560 <br /> Phone: (763)587-1799 Phone: ?(630)G8S -715 P <br /> Original Parcel Information sin <br /> Parcel ID#: 10207 Section 36 Township 38 North Range 15 West <br /> Lit <br /> Original Description(or attach copy): The Northwest Quarter of the Northwest Quarter(NW ''A NW 1/4)of <br /> Section Thirty-six(36),Township Thirty-eight(38)North. RangeWisconsin. <br /> S Fifteen(I 5) West, Burnett County, Wisconsin. 0� <br /> Current Zoning: RR I Floodplain Y/N: Yes Wetlands: Yes Lake/River Class: <br /> ti <br /> Name of Water Body: Clam River Shoreland Agreement/SIPS: No �. <br /> Farmland Preservation: No Managed Forestry Law: No. 1� <br /> New Parcel Information -40 <br /> P^ <br /> Proposed New Legal Description and Parcel Size: That part of the Northwest Quarter of the Northwest <br /> Quarter(NW NW'!,)of Section Thirty-six(36),Township Thirty-eight(38)North,Range Fifteen(I S)West, <br /> Burnett County,Wisconsin. lying north of the center line of the north fork of the Clam River. <br /> Acres: 20 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Buyer to obtain access through other properties owned by Buyer out to County <br /> Road B. <br /> Proposed access to public waters to he provided Y/N: Yes <br /> If yes,describe access: New property will have frontage on Clam River. <br /> Signature of Owner: Date: 7)79,,,,,,,,e4)&441,,,Tha- <br /> essica Pavlak,Trustee <br /> Signature of Owner: Date: <br /> Fee Rec: <br /> Check#: <br /> Does parcel meet Zoning Requirements' Yes No z- <br /> f <br /> ✓. <br /> % Does parcel require a Survey? Yes No i <br /> Y. <br /> Z <br /> Reconciles with Real Property Lister AD No Date: (a -5 - Q0,g3 ?' <br /> If not,explain: <br /> L� <br /> Applicatir Approved / 1• tied Reason for Denial: � F— <br /> a) <br /> lluu <br /> Ø7ii/'z .. :Land Use: Date: 0 i <br /> rvr o0 <br /> n <br />