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Fees pnnst accompany form)'. <br /> Burnett County Subdivision Permit Application Sttndr'sion wdo Sarwry: $50.00 <br /> Survey of Existing Parcel: $500011ot <br /> and/or Pre-Application-Form Snbdivisionw/Survey5200.00t550.00/101 <br /> c <br /> Owner: pat h"n Cal"'I�F<tate Buyer: to be deternined s <br /> C/o Wayne A. Saladis, Pers. Rep. <br /> Address: Address: <br /> 6045 Bushey Road <br /> Webster, WI 54893 <br /> Phone: (715) 866-7486 Phone: <br /> Original Parcel Information '� <br /> Parcel ID#: 07-020-2-00-16-25-201-000-011000 Section 25 Township 4ON Range 16W <br /> C <br /> Original Description(or attach copy): <br /> The lbrtheast Quarter of the Northwest Quarter (NH NWA) <br /> —' --.' -- '- -- -thereof- -- <br /> c Current Zoning: Floodplain Y/N: Wetlands Y/N: fake/River Class: O <br /> 9 <br /> Name of Water Body: Shoreland Agreement/SIPS Y/N: <br /> 0 <br /> Farmland Preservation Y/N: Managed Forestry Law YN: <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Parcel#1: The Ibrth 1ialf (N i ) of the NO Nd# (20 acres) <br /> Parcel#2: The NH 144 except the North 1/2 thereof Acres: 20 acres <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: nay need easermnt to Bushey Road O <br /> Proposed access to public waters to be provided YN: N <br /> J <br /> If yes,describe access: <br /> Signature of Owner: Date: <br /> ._ dts, Rep. <br /> Estate o thong J.-SaMdis,deceased—" <br /> Signature of Owner: <br /> 3 <br /> 9 <br /> Does parcel meel Zoning Requirements? Yes tN'o <br /> N u <br /> o . Does puree!require a Survey? Yes <br /> S <br /> D Permit applicalion fees submilled? KI Amount$ st+UO Receipt# <br /> r Q'Reconcik,x with Real Property Lister Yes No Date <br /> rl O <br /> If nut,explain: {zczt <br /> fsC� <br /> Applicmionti�Approved / enkc! Reason for Denial: SZl <br /> / O <br /> Land Use: / Date: z' <br />