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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+$5.00/lot <br /> Owner: („eQ_ W 2terE <br /> Address: �,y -7 3 0 z <br /> W hsE� -)__ titi xs '� Phone: 3'19 - 5474 <br /> Original Parcel Information PV <br /> A <br /> Parcel Identification #: CD ZZOS 0�f7c>oSection 5 Township s € Range Is B <br /> 0 <br /> Original Description (or attach copy): Oy- L d- G <br /> W <br /> �n A O <br /> > Current Zoning. Floodplain Y/N: Wetlands Y/N: � <br /> .9 '. <br /> Lake/River Classification: Name of Water Body: U f o L� LplL(�F <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: C5M <br /> Acres: A,S2 t <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: CSI to 9'0�k <br /> Proposed access to public waters to be provided Y/N: N d <br /> If yes,describe access: <br /> i <br /> ➢ Does parcel meet Zoning Requirements? Ye No a <br /> N ''~ <br /> °o ➢ Does parcel require a Survey? Y s No n <br /> °Q 3 <br /> ➢ Permit application fees submitted? Amount$ M Receipt # <br /> A <br /> e ❑ Reconciles With Real Property Lister Yes No Date: d <br /> a <br /> -C <br /> If not,explain: <br /> o <br /> a � <br /> U) <br /> I <br /> Applicatio Approved Denied Reason for Denial: -� <br /> I <br /> Land Use: h Date: <br /> 2/18/2003 <br />