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Burnett County Subdivision Permit Application Fccs(muslacwmpanyform): <br /> and/or Pre-Application Form Su division w/o Survey: $I0A0 <br /> '"� pll(J Subdivisionw/Survey:$100,00+$15.()0/Int <br /> Owner: ts-rra NcP_ Her }–� <br /> Address: 6ZZ-7 GLLLL L&K�, Di`i✓.e.. a <br /> h r , (moi 5q9 '2AQ Phone: X15-(056-32 <br /> q Original Parcel Information U II // I ,/ w <br /> Parcel Identification#:632-5336-679UU Section Township YIN Range !d W <br /> Original Description(or attach copy): LE f Y\ <br /> q p <br /> EG 07. 3 t�.tftIt s t� <br /> m Current Zoning: K2– -L Floodpan Y�l1': Wetlands N; <br /> a lity' <br /> Lake/River Classification: Name of Water Body: GULL L tzK2 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Acres: l8.35 <br /> (If parcel is to be surveyed,provide preliminary ma/p. See attached for preliminary map requirements.) <br /> Proposed access to public road: Gull Lit kQ <br /> e r l \/Qi <br /> p / O <br /> Signature of Applicant: ` —Date: A <br /> RiaJ <br /> N Y Does parcel meet Zoning Requirements? Yes No d <br /> ➢ Does parcel require a Survey? Yes No <br /> Q p e <br /> D Permit application fees submitted? El Amount <br /> Amount��U 0 Receipt# U CJf �S 3 <br /> 9 <br /> C <br /> ❑Reconciles with Real Property Lister Yes No Date: <br /> 6 <br /> oIf not,explain: CAJ <br /> a <br /> UI <br /> II w <br /> Application: / Denied Reason for Denial: tc4e <br /> w� � <br /> Land Use: <br /> Date: <br />