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Burnett County Subdivision Permit Application Fees(must acc n NNED <br /> Subdivision w/o Survey: $10.0;+$5.00/lot and/or Pre-Application Form Subdivision w/Survey: $25.0 <br /> Owner: G2EG62. ! yf®FF k' , �yhn , P�' tV �. <br /> 7 1' <br /> Address: / g� /�rd /�.Q.. eEt�_ <br /> 6 no qr' &A, �� 5�yag Phone: -16 5-yZy- 6066 w6kK <br /> (D/ oQ <br /> 3(0-`1413 -03 4 o0 Original Parcel Information <br /> 'X``4`113 -63 �aov /� t� <br /> Parcel Identification #: 34,-W`113-b3 10/bU Section —L Township Range <br /> /' q z <br /> Original Description (or attach copy): V•L , - L0� g O'ry Zer <br /> O <br /> Current Zoning: Floodplair�Y N: Welland Y N: <br /> �• Lake/River Classification: Name of Water Body: 1 A5 5 LAgE <br /> n 1 <br /> o � <br /> New Parcel Information ) <br /> Proposed New Legal Description and Parcel Size: <br /> V, ao Pt a02--ao� <br /> Acres: 5 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 7Q Im bbrq Iglu V� <br /> Proposed access to public waters to be provided Y& d <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> c� <br /> N <br /> ➢ Does parcel require a Surrey? Yes No / c <br /> ➢ Permit application fees submitted? Amount$ 19 q,(h Receipt # U_7S <br /> ❑ Reconciles With Real Property Lister Yes No Date: •O <br /> a L.1 <br /> If not, explain: G -c- <br /> o Z <br /> CY <br /> a C <br /> 1 <br /> H a <br /> p ^ 1 <br /> Application: Approved Denied Reason for Denial: see (JtZ0&"e p SQ (L}.1 (I} <br /> Land Use: Date: <br /> 2/18/2003 <br />