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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: 525.00+$5.00/lot <br /> Owner: e56" SM t rI.L , 15GA.T72-I OG S m ITI" � FAeu u uxrz_Sd <br /> Address: ZS 7 7 H U*' M081L_V DR <br /> C&MA-6G (SIZ O✓t: , W L 53527 Phone: ,609 $39 -36S') <br /> Original Parcel Information <br /> B <br /> Parcel Identification#: S ZI 19 v 14-Oo SectionV-2 Township '38 Range 14— z <br /> 0 <br /> Original Description (or attach copy): 8 ZI 19 0 1 1 CIO <br /> 8Z119a1 zoo <br /> 0 <br /> Current Zoning: ,21Z/ Floodplain Y/N: Wetlands Y/N: Al <br /> Y ' <br /> ro I .". <br /> Lake/River Classification: Z Name of Water Body: 13 AS (+AvJ <br /> d <br /> 0 <br /> New Parcel Information n <br /> Proposed New Legal Description and Parcel Size: L'S rA rl P t f7 o <br /> No N6-. Pic l✓L S . VUST— lZ_V+A 2R AN61 Q 6 L01- L I YQ V5 <br /> 7-6 n D y up DgS c2 f p r o IJ S Acres: 10 • S <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: PV13Lt c 12616,p I C'&SC--AA 7P,-T- TM SOUTH- PAe e- <br /> Proposed access to public waters to be provided Y/N: nJ .9- d <br /> A <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N <br /> o ➢ Does parcel require a Survey? Yes No <br /> o' o <br /> ➢ Permit application fees submitted? Amount$ "" Receipt # �l� r <br /> A <br /> , <br /> zk <br /> r Reconciles With Real o. Property Lister No Date:s <br /> Q <br /> If not,explain: ac <br /> fn <br /> Applicati : A ro / Denied Reason for Denial: <br /> c� t <br /> Land Use: Date• ��o� 3 <br /> 2/18/2003 `r <br />