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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 <br /> p Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: �C2L Q�"!U�D /S�_/02i/9(� l li'5 <br /> Address: /17 d UL'-fX�gh4i- //lS�/�/✓� p��J"`� <br /> �� / /l 76�c Z Phone: b 17- 3�9— <br /> 3 /ozo - -oUje-JL R <br /> Original Parcel Information A <br /> Parcel Identification #: 7Or7�-yl-���3'C� 6/Section /J Township y1,41 Range�W <br /> z <br /> Original Description (or attach copy): <br /> O <br /> ,p <br /> Current Zoning: Flood lai wetland <br /> 10 <br /> �\ p <br /> = 3 Name of Water Body: �� S <br /> Lake/River Classification: <br /> d <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Cpm V � � <br /> �D <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: a�`3 <br /> Proposed access to public waters to be providet�Y/N: <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements? YeNs No T <br /> 2p p�N <br /> a ➢ Does parcel require a Surrey? }'es NoTQ <br /> ➢ Permit application fees submitted? ] Amount $ �• Receipt # 3 / <br /> ry <br /> a <br /> Reconciles with Real Property ListerYes No Date: Q� <br /> a <br /> If not, explain: <br /> 1 <br /> 0 <br /> a C.� <br /> CU <br /> Applicati< Approved / enied Reason for Denial: <br /> I <br /> Land Use. Date: ~ /� <br /> 2/18/20031 <br />