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Burnett County Subdivision Permit Application Fees(must accompany foram): <br /> Subdivision w/o Survey: SI0.00 <br /> and/or Pre-Application Form Subdivision w/Survey:S100.00+S15.00Aot <br /> Owner: Rurick R. & Frances Mattson <br /> Address: 11295 Mattson Rd. <br /> Luck, WI 54853 Phone: 715/327-8264 <br /> A <br /> Original Parcel Information 3 <br /> Parcel Identification#: 034-1535-01700 Section 35 Township 37 Range 18 o <br /> Original Description(or attach copy): Parcel in NW NW, 35-37-18 Commencing <br /> at SE corner , thence N. 80 rods , thence W. 80 rods, thence S . <br /> 80 rods , thence SEly to point of beginning , except W. 4501 . p <br /> ma <br /> Y Current Zoning: AG Floodplain Y/N: N Wetlands Y/N: N <br /> V <br /> Lake/River Classification: N/ A Name of Water Body: N/A <br /> New Parcel Information V\ 5�Z\ <br /> Proposed New Legal Description and Parcel Size: (See attached map) . <br /> 1 <br /> Acres: in <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: via Mattson Road <br /> v <br /> Proposed access to public waters to be provided YIN: N A <br /> C4 <br /> If yes,describe access: Ohl <br /> V <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> n <br /> ➢ Does parcel require a Survey? Yes No e <br /> q e <br /> ➢ Permit application fees submitted? ❑ Amount S ©' Receipt# J 33 ^x, <br /> a <br /> rc <br /> e ❑ Reconciles With Real Property Lister Yes No Date: S <br /> a � pp e pe _ <br /> If not,explain:l7� n c�Q 7 oA V a Cn,t o V- LVA t) l/1 Q C LLi.A'o-k X11 <br /> 3 ' U1 <br /> a 1 <br /> 0 <br /> bZ O� q- C-JL QAA.3 rY'm CL — <br /> Appncadon: A proved Denied Reason for Denial: J <br /> FL rem <br /> Land Use: Date: <br /> 2/18/2003 <br />