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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: $25.00+$5.0011ot <br /> Owner: TM ThD/ L 7'_�/1I <br /> Address: (o ZS 7 Gv l t LAlf c OiCiy{ / <br /> � 7�y <br /> 04hY IN (i .-487- Phone: 61 Z. 977 % 8408 <br /> Original Parcel Information V <br /> A <br /> - / 3 <br /> Parcel Identification #: 6 J� 53�� '��J��� Section 56 Township 1111V" Range Range 16 z <br /> Original Description (or attach copy): h�y J`rc l orro( Poe.#o ?¢¢fo Z <br /> JP <br /> W <br /> OQ <br /> O <br /> Y <br /> Current Zoning: `� Floodplain N: [/Jki �Vetla�ndsG2/N:"fw"L <br /> Lake/River Classification: <br /> 2 Name of Nater Body: <br /> d <br /> 0 <br /> New Parcel Information S <br /> 0 <br /> Proposed New legal Description and Parcel Size: L'�yj�l, ek%Jf'hk pQP-V--r( <br /> a <br /> MAr a i9r.d s <br /> Acres: /. �l) <br /> (If parcel is to be surveyed, provide preliminary map. See attached/for preliminary map requirements.) <br /> Proposed access to public road: 1 / /q/�� /�'ft ✓t <br /> Proposed access to public waters to be provided N tv <br /> d <br /> If yes, describe access: L lf-c e_t i W <br /> Q.> <br /> ..n <br /> ➢ Does parcel meet Zoning Requirene s? Yes No a <br /> N � <br /> °o ➢ Does parcel require a Surrey? Yes No n <br /> `o' o <br /> � 3 <br /> ➢ Permit application fees submitted? ❑ Amount S Receipt # °e <br /> at <br /> ❑ Reconciles With Real Property Lister Yes No Date: <br /> a W <br /> If not, explain: <br /> 0 <br /> � W <br /> a <br /> y <br /> 1 <br /> Applica ' n: Approved ! nied Reason for Denial: �1 <br /> w <br /> 8 <br /> Land Use: Date: —�7 S <br /> 2/18/2003 <br />