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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/ P_ - <br /> j Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: &-7/z' - �1 c6a_ <br /> t 'p--7 <br /> C�l <br /> Address: ��3(0� 1 ( l/ led— ' <br /> �Lr2 �culr�: jii= 5 8,m Phone: <br /> Original Parcel Information <br /> 7/0 �� S 3� /c4 9 <br /> Parcel Identification#: �4o?"G�SOS^�3�- Sechon Township Range z <br /> 0 <br /> Original Description(or attach copy): PC/ / n S tc, Yl/ b - 3 - <br /> Woo /'Ver <br /> LJ <br /> (7/D is la3(oo2 ctu IF(I -1) — "1"3178 Eta ''d <br /> Current Zoning: l t/1 7i, Floodplain Y/N: /I Wetlands Y/N: <br /> o <br /> =• Lake/River Classification: — Name of Water Body: <br /> m <br /> 0 <br /> New Parcel Information C} / <br /> Proposed New Legal Description and Parcel Size: W rn / P65-6(o <br /> L I a• 9a <br /> Acres: L R 4/, (, 7 p <br /> L 3 S. 00 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: t7 7-D <br /> Proposed access to public waters to be provided Y/N: — A-1 o <br /> A <br /> If yes,describe access: — , <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N W <br /> °a ➢ Does parcel require a Survey? Yes No c <br /> ➢ Permit application fees submitted? Amount$ h/0'00 Receipt# 39 <br /> e <br /> A <br /> �s <br /> Reconciles With Real Property Lister Yes No Date: C <br /> If not, explain: <br /> 0 <br /> a <br /> y <br /> Application: pproved / Denied Reason for Denial: <br /> n qq 1 <br /> Land Use: 4- Date: p <br /> 2/18/2003 <br /> C <br />