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Burnett County Subdivision Permit Application Few(must smompsny foam): <br /> Subdivision w/o Survey: $10.00 <br /> ft <br /> -ApplicationForm Subdivision w/Survey:si00M+sls.00nat <br /> 1�li <br /> Owner: -tcAe ll r 'LU H&— <br /> Address: _6509 7vvL azAV <br /> I Bro ok� A/ /4L r-k M/✓,Mlphone: <br /> Ori¢inal Parcel Information n <br /> Parcel Identification N:632-.V311-L,446 Section :k/ Township Range / p <br /> Original Description(or attach copy): - IA/ ZZ- S �/�/�✓ G3EO <br /> Current Zoning: Q <br /> ' 1 3 Floodplain Y/N: Wetlands Y/N: i <br /> PC <br /> Lake/River Classification: Name of Water Body: EAGLE LAKE <br /> �- <br /> New Parcel Information b <br /> Proposed New Legal Description and Parcel Size: L/ ;�-/n P <br /> s <br /> Acres: Zo, Z� <br /> (If parcel is to be surveyed,provide preliminary map. See <br /> LAKE <br /> attached for preliminary map requirements.) <br /> Proposed access to public road: EA6(.6- LAKE Rb 0,Q <br /> Proposed access to public waters to be provided Y/N: g <br /> If yes,describe access <br /> O <br /> ➢ Does petrel meet Zoning Requirements? Y No <br /> � 0➢ Does parcel require o Survey? Yes No g <br /> a'a $ <br /> ➢ 'Permit application fees submitted? ❑ Amount$130, C) Receipt# Z) '1 <br /> x <br /> OG <br /> ❑ Reconciles With Real Property Lister Yes No Date: �U) <br /> If not,explain 0 t? <br /> a ww <br /> Application Approv / Denied Reason for Denial: MCC, <br /> Land Use: Date: j' 8'��l <br /> 2/18/2003 <br />