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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 /> It <br /> Shirley Scanlon <br /> Owner: Buyer: <br /> d <br /> Address:2401 County Rd A Address: o <br /> Webster WI 54893 1j <br /> m <br /> N <br /> Phone: Phone: A <br /> Original Parcel Information <br /> Tax ID#: 07-028-2-40-14-21-2 01-000-011000 Section 21 Township 40 Range 14 <br /> O <br /> Original Description(or attach copy):N E-N W <br /> Current Zoning: C1 Floodplain Y/N-N Wetlands Y/N: Y Lake/River Class; <br /> Name of Water Body: Shoreland Agreement/SIPS Y/N: <br /> Farmland Preservation Y/N:N Managed Forestry Law Y/N: N <br /> New Parcel Information d <br /> Proposed New Legal Description and Parcel Size: 2 Lot CSM <br /> I„ <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 /> Proposed access to public waters to be provided Y/N: ` <br /> If yes,describe access: <br /> I <br /> ➢ Does parcel meet Zoning Requirements? Yes No Fee : 3�. <br /> Checckk#:6/o9.S- <br /> ➢ Does parcel require a Survey? Yes No <br /> Reconciles with Real Property Lister Yes No Date: <br /> If not,explain: <br /> Application• Approved / enied Reason for Denial- <br /> Lan e• Date: <br /> zo Z0Z74/ <br />