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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 Subdivision w/Survey: $25.00+$5.00/lot <br /> Owner: —�� I�GINtk/46 <br /> Address: z-71-715— r'o"6 7^p��J/� rib, ,�j// p� <br /> EQST�� W I ST 8 Phone: UM, <br /> — <br /> Fa V+ Orieinal Parcel Information ro <br /> Parcel Identification #: d ZO y?L9- O 15!6e) fG 3 <br /> AND _ OZ-77C00— <br /> Section Township Range z <br /> /- c <br /> Original Description (or attach copy): Ek CS L-'Oy LO` C a- 7 <br /> v< < een <-t Low � Ao4n <br /> 04) <br /> Goy,got ZeR( �/ p <br /> Current Zoning: GQV,Lot I N23 Floodplain Y/N: NJ Wetlands Y/N: <br /> V <br /> m <br /> Lake/River Classification: Name of Water Body: <br /> 1 <br /> New Parcel Information ':E; . <br /> W <br /> Proposed New Legal Description and Parcel Size: He L O <br /> CSM -7 Z A c2 S <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. /See attached for preliminary/map require nts.) <br /> Proposed access to public road: bM e& A Ices JO LONt`, PIN(5_ <br /> �iq 13 <br /> Proposed access to public waters to be provided Y/N: �_ C <br /> m <br /> If yes,describe access: <br /> i <br /> c� <br /> ➢ Does parcel meet Zoning Requirements? Yes No 0 <br /> N <br /> ➢ Does parcel require a Survey? Yes No n <br /> o <br /> 3 <br /> ➢ Permit application fees submitted? Amount$� Receipt# bg1ti � <br /> A <br /> -, <br /> r �c <br /> ❑ Reconciles With Real Property Lister YesNo Date: �y <br /> a � <br /> If not,explain: �' G <br /> i <br /> CL <br /> -S <br /> Application: roved / Denied Reason for Denial: o O <br /> J <br /> G <br /> Land Use: Date: a <br /> 2/18/2003 <br />