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Owner: Dallas L. Oman & Mary H. Dahlin -Oman Buyer: Zachary Lener <br />Address: 25449 Forli Ave. Address; 508 W Faith Lane <br />Wyoming, MN 55092 Grantsburg, WI 54840 <br />Phone: (651) 429-6603 Phonei (715)-431-0933 <br />Original Parcel Information <br />Parcel ID #: 07-040-2-39-19-33-2 04-000-011000 Section 33 Township 39N Range 19W <br />Original Description (or attach copy): Southeast Quarter of the Northwest Ouarter, Section 33, Township <br />39 North, Range 19 West, Town of West Marshland, Burnett County, WI. <br />Current Zoning: JGO1Floodplain Y/N: N <br />Name of Water Body: <br />N <br />Farmland Preservation Y/N: <br />N/A <br />19 <br />Wetlands Y/N: N Lake/River Class: N/A <br />Shoreland Agreement/SIPS Y/N: N/A <br />Managed Forestry Law Y/N: N <br />a� <br />New Parcel Information <br />Proposed New Legal Description and Parcel Size: North Half of the Southeast Quarter of the Northwest <br />Quarter, Section 33, Township 39 North, Range 19 West, Town of West Marshland, Burnett County, WI. <br />Acres: 20 <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: Gile Road <br />Proposed access to public waters to be provided Y/N: N/A <br />If yes, describe access: <br />Signature of Owner: I Date: <br />Signature of Owner: �-- Date: <br />➢ Does parcel meet Zoning Requirements? Yes No <br />N ➢ Does parcel require a Survey? Yes No <br />0 <br />Permit application fees submitted? Amount $ -'DU , IJU Receipt # <br />❑ Reconciles with Real Property Lister Yes No Date: <br />t" <br />If not, explain: <br />a <br />0 <br />o. Applicatio Approve / enied Reason for Denial: <br />Land Use: p Date: U Lull <br />BURNETT COUNTY <br />d <br />m <br />Fees (must accompany form): <br />Burnett County Subdivision Permit Application <br />Subdivision w/o Survey: $50.00 <br />Survey of Existing Parcel: $50.00/lot <br />and/or Pre -Application Form or Map Review Form <br />Subdivision w/ Survev: 8200.00 + $50.00/lot <br />Owner: Dallas L. Oman & Mary H. Dahlin -Oman Buyer: Zachary Lener <br />Address: 25449 Forli Ave. Address; 508 W Faith Lane <br />Wyoming, MN 55092 Grantsburg, WI 54840 <br />Phone: (651) 429-6603 Phonei (715)-431-0933 <br />Original Parcel Information <br />Parcel ID #: 07-040-2-39-19-33-2 04-000-011000 Section 33 Township 39N Range 19W <br />Original Description (or attach copy): Southeast Quarter of the Northwest Ouarter, Section 33, Township <br />39 North, Range 19 West, Town of West Marshland, Burnett County, WI. <br />Current Zoning: JGO1Floodplain Y/N: N <br />Name of Water Body: <br />N <br />Farmland Preservation Y/N: <br />N/A <br />19 <br />Wetlands Y/N: N Lake/River Class: N/A <br />Shoreland Agreement/SIPS Y/N: N/A <br />Managed Forestry Law Y/N: N <br />a� <br />New Parcel Information <br />Proposed New Legal Description and Parcel Size: North Half of the Southeast Quarter of the Northwest <br />Quarter, Section 33, Township 39 North, Range 19 West, Town of West Marshland, Burnett County, WI. <br />Acres: 20 <br />(If parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br />Proposed access to public road: Gile Road <br />Proposed access to public waters to be provided Y/N: N/A <br />If yes, describe access: <br />Signature of Owner: I Date: <br />Signature of Owner: �-- Date: <br />➢ Does parcel meet Zoning Requirements? Yes No <br />N ➢ Does parcel require a Survey? Yes No <br />0 <br />Permit application fees submitted? Amount $ -'DU , IJU Receipt # <br />❑ Reconciles with Real Property Lister Yes No Date: <br />t" <br />If not, explain: <br />a <br />0 <br />o. Applicatio Approve / enied Reason for Denial: <br />Land Use: p Date: U Lull <br />BURNETT COUNTY <br />d <br />m <br />