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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+$5.0011ot <br /> Owner: AA/p,y►JM AUC, A0Pcwfcd,J <br /> Address: P 0. .B04 1-53 <br /> Grz ALTs 5U MG, 1J-t- 5484.0 Phone: 4-G`3 – 317 7 <br /> Original Parcel Information <br /> 3 <br /> Parcel Identification M 047. Z9_06 Section S Township 3 a Range 1i�> z <br /> e�3 10o p <br /> Original Description (or attach copy): <br /> 12C4 ,Sill/ SY1 w <br /> U) <br /> U� <br /> 0 <br /> o Current Zoning: ^/ A- Floodplain Y/N: Sam6- Wetlands Y/N: St-"We= <br /> V p � <br /> Lake/River Classification: '`' ��:—iZ Name of Water Body: WOOD j?IV <br /> SMAS PPt2— 15 win+, 3c)o t eF= Mto,%j <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Z I_oT SM <br /> 0'S U Ia <br /> Acres: J Z 7aTA-t.-- <br /> (if parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: I Lam SN LGA-SEMLrrJ?— <br /> Proposed access to public waters to be provided YIN: rj d <br /> m <br /> If yes,describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> o ➢ Does parcel require a Survey? Yes No e <br /> ➢ Permit application fees submitted? fIJ Amount$ �Q �� Receipt 7t 3D o <br /> e <br /> A <br /> r ?t <br /> Reconciles With Real Property ListerYes No Date: a <br /> If not,explain: 4&& tnf <br /> o <br /> a <br /> Vi <br /> Applicatio Approve Denied Reason for Denial: <br /> c ti <br /> W <br /> I <br /> Land Use: Date: <br /> 2/18/2003 <br />