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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey:S100.00+§15.00/lot <br /> Owner: 7D6WkS (J Ex)- zkjELL <br /> Address: z X O / A<—. 4I~C <br /> Le <br /> L �TY l S�c � Phone: <br /> A <br /> Original Parcel Information B <br /> 2 f� <br /> Parcel Identification#: 6�-S-y I�I— 63 Secastion (. I Township Lf Range (e�' <br /> Original Description(or attach copy): <br /> N� <br /> T <br /> Current Zoning: Floodplain /N: Weda s <br /> Lake/River Classification: 1 v� Name of Water Body: <br /> m <br /> 0 <br /> w N <br /> t <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: rn <br /> .:5 <br /> Acres: <br /> (if parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> m <br /> Proposed access to public waters to be provided Y6). - <br /> If <br /> :If yes,describe access: / v <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> A <br /> ➢ Does parcel require a Survey? Y No e <br /> 0 <br /> e <br /> ➢ Permit application fees submitted? ❑ Amount$ Receipt# <br /> u <br /> b <br /> ❑ Reconciles With Real Property Lister Yes No Date: <br /> a � <br /> If not,explain: W <br /> o � <br /> a c <br /> . w <br /> d <br /> Application: pproved / Denied Reason for Denial: G <br /> Land Use: Date: <br /> 2/18/2003 - <br />