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Imo"_ <br /> Date Filed <br /> PREAPPLICATION CONSULTATION FORM <br /> REQUEST FOR APPROVAL - SUBDIVISION <br /> BURNETT LAND USE DEPARTMENT, BURNETT COUNTY GOVERNMENT CENTER <br /> SIREN, WI 54872 <br /> APPLICANT: OWNER: WAgp6,V O. LARSov <br /> 26745 Lakeland Avo. N. 9649 yllklN <br /> Webster, wl 5M3 /h�nnsor.l.? Jhb. SS 438 <br /> n�ai a�a�oR <br /> Phone: <br /> Phone: <br /> Location of Property: G �- s LoF Z C-fA Y./ ¢ or Z»� <br /> Co F 7 Vol 7 6 117-1/8) Parcel No. <br /> Ran e r Size <br /> Section S Township_ 9 <br /> Legal description attached. py Gjhe <br /> GS1�1 U 7 11 -//8 CXA V1 Py ZJ <br /> Names of Subdivision: <br /> Land Surveyor preparing plat: <br /> P <br /> Number of Lots Z Current ZoningProposed Zoning_ P <br /> Will a Planned Unit Development be required <br /> Proposed water supply Eh/ST//1 P-0119TE <br /> Proposed sewage system EA/Jl/N6 P/tt& <br /> Proposed uses: Residential x Commercial Park/Public <br /> Date g j/3/92 Signature <br /> Fees Collected: <br /> Date of Land Use Committee preliminary acceptance <br /> Action <br /> Date of Land Use Committee final acceptance Action <br />