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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 Subdivision w/Stavev: $200.00+$50.00/lot <br /> Parcel#1 Julie T. Hughes & Richard C. Hopkins <br /> Owner:Pa cel#2 Julie T.ggHughes Buyer: Tirmthy S. Hughes e <br /> Address: 27689uHig�y 35 es Address: 27689 Highway 35 <br /> Webster, WI 54893 Webster, WI 54893 <br /> Phone: (715) 791-(1824 Phone: (715) 856-d799 !; <br /> Oa0-4316w1-D-00 OrisinalParcel Information ) <br /> dao• 1431b ol-3o6 �j <br /> Parcel ID#: See attached Section 16 Township 40 Range 16 <br /> Original Description(or attach copy): See attached <br /> n, <br /> _ t <br /> 9 Current Zoning: Floodplain Y/N: Wetlands Y/N: Lake/River Class: <br /> g % <br /> Name of Water Body: Shoreland Agreement/SIPS Y/N: <br /> » <br /> Farmland Preservation Y/N: Managed Forestry Law Y/N: <br /> New Parcel Information <br /> A <br /> F <br /> Proposed New Legal Description and Parcel Size: r <br /> see attached 1##11 <br /> East Half of each forty to Timothy S. Hughes Acres:Parcel#2: H + 28 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: CCC Road C <br /> m <br /> A <br /> Proposed access to public waters to be provided Y/N: N <br /> If yes,describe access: 47— <br /> t <br /> Signature of Owner: tu Date: O <br /> t e IT. Hag s 4- U. 10 Signature of Owner: _Date: 4- U• 1 D 9 <br /> Ki chard ins S <br /> Y Does parcel meet Zoning Requirements? es No 'J" `l'do-!O m <br /> x <br /> ➢ Does parcel require a Surnev? Yes No o G <br /> a <br /> 04 ➢ Permit application fees submitted? ❑ Amount$ 5b• n U Receipt# p <br /> t <br /> t � <br /> �., El Reconciles with Real Property Lister No Date: W W <br /> 0. 6' <br /> a If not,explain: O Q <br /> CL O O <br /> h O <br /> ApplicatioApproved enied Reason for Denial: <br /> Land Use: � �.�-----_._.._ Date: <br />