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Burnett County Subdivision Permit Application Fecs(mun accompany fo m): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey: $25.00+$5.0011o1 <br /> Owner: Duo-., , w.5l ".f <br /> Address: 2V 357 0r&� 6,rr.I Mn.. Wc,o <br /> 46 S ei � WS S 4 F1 Phone: _ 3Y9 - z37y <br /> Orieinal Parcel Information A <br /> Parcel Identification #: 01i-Ze0!O"0130DSectlon, 9 Township 2 g Range <br /> e <br /> Original Description(or attach copy): <br /> 90 <br /> y Current Zoning: W— FloodplainL/ Wetlands Y 1: n <br /> a Lake/River Classification: 7 Name of Water Body: <br /> LAI,- <br /> R}lLN�2 <br /> nm � <br /> ° P <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: F <br /> V'f O (L , J_ Gtt/C-Q� ,ate <br /> A <br /> Acres; <br /> (If parcel Is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: d <br /> If yes,describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No d <br /> ➢ Does partel require a Survey? Yes No c <br /> 3 <br /> ➢ permit applica(ionjees submitted? ❑ Anmun($51) GD Receip! # <br /> n <br /> u <br /> ❑ Reconciles With Real Properly Lister Yes No Date: O <br /> a <br /> If not,explain: 'C <br /> 'e ql <br /> u <br /> Applicatio Appro / Denied Reason for Denial: <br /> 0 <br /> Wp <br /> Land Use: Dale: (p 6Y <br /> 2/18/2003 <br />