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rrig#tartetatOari*MY ha* <br /> Burnett County Subdivision Pennit Appkation subr.iiimoOnvar moo <br /> sastireFogitheoaratit Meant <br /> andfor Pre-Application Form or Map Review Form Sakdivirice Stever=MOO 4-9:10.00/1ot <br /> Jowl Harty &arm <br /> Add.:PO Box159 r <br /> Addreet. <br /> Danbury WI 5030 <br /> Phone: 71 5--Y,(5 76.) 0 Phone. 9k <br /> Tax m 37056&37057 <br /> Orieinal Parcel Information <br /> sectio29 Towasidpil_asise ie o <br /> Original Description(or attach copy):Lots 22&23 of CSM V31 P87 <br /> Current 7.06,c2Fb.dpiataistR3 - WethewititIN:N Lake/River Cbter. - <br /> Name of Water Itodr: Shoreland.Agreement/SIPS YiNt <br /> Farmbed Preteetedeti YiN:N Managed Foresiry Law YIN: N <br /> New Farm'Jnfo <br /> Proposed New Legal Description and Pared Size: 2 Lot CSM of existing parcels 7 <br /> Acre <br /> (If parcel is to be surveyed,provide preliminary amp. See attached for preliminary map Tottoltesusts-) <br /> ' Proposed access to pubic road: <br /> :1$ <br /> Proposed access to puhfic waters to be provide' d <br /> If yes,describe twee ., t-11 <br /> If` <br /> &Vila kt re of Owner t"•-• <br /> 0 46-- <br /> gig,04ftne.of On a" -OE <br /> Fee Itecq00•Doespereel ereecZoningRequirinnents? Yes Na • <br /> Check* <br /> - Doi s pan*t require Survey? Yes No <br /> Reconciles with Rent Property Litter Yes No Date <br /> If not,eepNin- <br /> Appliend0CApealect Reason for Denial- <br /> Date: <br /> 11 <br />