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Burnett County Subdivision Permit Application Fees(must accompany forth): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey:$100.00+$15.00/lot <br /> Owner: le-26`I-I-- TD FICA - tiM -� ma- CIL a~ �"` 3UU <br /> Address: 7Z-4 <br /> 35/70 <br /> Phone: <br /> / Ori¢inal Parcel Information /,/ <br /> Parcel Identificat;on#: b 3(c-yy�1-6-3760 Section�Township ��Range 1'7W ro,� <br /> Original Description (or attach copy): L, (O LD4 1.3 D $4S <br /> p«dVJ24spy ¢2e <br /> Current Zoning: ✓22�- Floodplai6N: Lnkc Wetland_ <br /> Lake/River Classification: Z Name of Water Body: FF LGt/� <br /> m <br /> 0 <br /> O <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: L _5 / /A/ Cfj� <br /> Acres: <br /> las <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 6 L t4 k,4'� La,/z�- rce - <br /> C <br /> Proposed access to public waters to be provided 4kc 4I <br /> If yes,describe access: <br /> i <br /> ➢ Does parcel meet Zoning Requirements? Yes No /RE509U6-y o6 6�4 57l o L3 <br /> °o ➢ Does parcel require a Survey? Yes No ° <br /> a <br /> ➢ Permit application fees submitted? ❑ Amount$ Receipt# <br /> r a <br /> ❑ Reconciles With Real Property Lister Yes No Date: <br /> a <br /> If not,explain: s <br /> o 4 <br /> a <br /> w <br /> r <br /> Application Approved Denied Reason for Denial: O <br /> W <br /> Land Use: ( Date• <br /> 2/18/2003 <br />