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• <br /> Original Description(or attach copy): Plat of Grupe Add Lot 2 <br /> current Zoning: RRi Floodplain YIN: N Wethnds YIN: N <br /> Name of Water Body: NA Shorebird Ag <br /> Farmland Preservation YlN: Managed Forestry Lave I <br /> New Parcel Inforraatiot <br /> Prosed New Legal Description and Parcel Size: <br /> Acres: <br /> (I parcel to to be surveyed,provide preliminary map. see attached for prelimin <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: <br /> 17 <br /> Signature of Owner: <br /> Signature of Owner: D <br /> ➢ Does parcel neer Zoning Regukements? Yes No <br /> Does panel r etire a Survey? Yes � o <br /> Permit application fees submitterf� 0 .!mount S <br /> ©Reconciles with Real Property Lister Yes No Date: <br /> if not,explain: <br /> Application: Approved 1 Denied Reason for Denial: <br /> Land Use: Date: <br /> 1,-.4.17A,... '' <br /> 4. rx"- ' �gtjIt' ",�� € z <br /> 1. <br /> • <br /> • ' '3 .rb ,:7",''4' � _ 'fr ; ,mra r .2 ' ter*, t:.:''''.',-..1,:::, <br /> ' 4 ' ats a- <br /> • f? ` s � q 'r',, a, fir;. : + �ii " a „.S` ' 94teA4.16Wr ,S ,a 3'r 4,e,4.:,-.1/4., <br /> E 6 <br />