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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey:$100.00+$15.00/lot <br /> Owner: Melissa Sogge <br /> A <br /> Address: Box 431 B <br /> Milltown,WI 54858 Phone: 715-825-4357 Z <br /> 0 <br /> Original Parcel Information CA <br /> Parcel Identification#:020-9225-03400-020-9225-03-500,020-9225-03-500 Section 32 Township 40 Range 16+ <br /> Original Description(or attach copy): Lots 15 16 and part of 17 as described in the attached deed <br /> Norh a Je �ies Lla <br /> Current Zoning: PUD Floodplain Y/N: —N° Wetlands Y/N: No <br /> o Lake/River Classification: 1 Name of Water Body: Yellow Lake lP" <br /> UQI <br /> New Parcel Information <br /> ProposedNew Legal Description and Parcel Size: See attached copy <br /> / <br /> ISM <br /> Acres: 1.39 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: Washington Street <br /> Proposed access to public waters to be provided Y/N: Y e s <br /> If yes,describe access: d <br /> Signature of Owner: Date: <br /> .-A <br /> ➢ Does parcel meet Zoning Requirements? Y No J <br /> 0 <br /> ➢ Does parcel require a Survey? es No <br /> Permit application fees submitted? ❑ Amount$ �IV b Receipt# <br /> C <br /> A <br /> t ❑ Reconciles with Real Property Lister Yes No Date: <br /> CL <br /> o �Q <br /> If not,explain: o o o <br /> e s-S)W <br /> ocP <br /> WIV U+ <br /> Applicatio Approved / enied Reason for Denial: ¢w <br /> Land Use: Date: �l �� <br />