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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/Survey: $200.00+$50.00/lot <br /> r. 10 <br /> Gerald_& Norma Fiedler <br /> Owner: Buyer: p. <br /> 13878 Bistram Rd <br /> Address: Address: - <br /> Grantsburg, WI 5484046, <br /> Phone: — 36 -5638 Phone: c <br /> art at Parcel.Information <br /> Tax ID#: 07-040-2-39-19-27-4 04-000-011000 Section• 27 Township 39N Range 19W <br /> Original Description(or attach copy):SE-SE <br /> O <br /> A <br /> t.1 <br /> Current Zoning: RR3 Floodplain Y/N:N Wetlands Y/N:Y Lake/River Class: <br /> Name of Water Body:N/A Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation YIN:N Managed Forestry Law Y/N: N <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM h <br /> rV <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) y <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: . <br /> Signature of Owner: t".7 ''' r(7. ' 1 < f—.c C)-1012 Date: .,"t ' <br /> Signature of Owner: Date: <br /> > Does parcel meet Zoning Requirements? Yes No Fee Rec ZSb <br /> Check#: 6 0760 <br /> > Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister Yes No Date:: 14. <br /> If not,explain: <br /> a <br /> Applicatio, Approved / ►enied Reason for Denial. <br /> Land Use: Date: <br />