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r.c:(r„,i a..orapan, Iron). <br /> Burnett Count' Subdivision Permit Application SubJi.amnw/osur,.y: sspaaX 3, <br /> Suo", oft: 'Urg N,'I- 8i000not <br /> and/or Pre-Application F�o7r�m Sabdmbh'nwr Sur,W7. SIM.00 : S5000/hu <br /> Owner: /��/C�IA'C /gy////f"yLi/EZ� ✓R(lyer: -s <br /> Address: -71M7 7J 9h /pA19C'� 41E' Address: = <br /> ,a��arlvs ✓.//� QUA 9Y.�71-/ <br /> Phone: 3�zg' 7�.1-/�C� Phone: <br /> L <br /> Original Parcel Information ' <br /> U1 <br /> Parcel IDk: C//_ Section�_'I'owmshill 3j79 R:mge r <br /> J�J z � <br /> Original DcsAj nOyyrel attach copy): Al SGc. / la s <br /> d•-��_c-'/2^Jilad��Ufi-�o-53-cIL �� -�.u)���- <br /> Z,oaing:— <br /> Same of Water Bad,: �Ci✓E Slo reland Agreement/SIPS Y/N• 70 <br /> C <br /> Farmland Preservation Managed Forestry Law <br /> New Parcel Information <br /> Proposed Nem Legal Descriptionand Pnrcel Size: 15- <br /> �i / ,:.[� »%3 -1�,1 -�/ua/y -,✓tJ�Y SES/L t��ifh E%2_Ey2 -<Yd-,c!�,�%f-.ui✓/'%/L <br /> ��� fA W Ys -wYa . 4G Xq(- /f / <br /> Acress /S✓/c.OES E.Az'_{I <br /> (if parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 2:),kE ,ef, - e(l(J <br /> 1'roposed access to public watersto be prorided\'/S: if/p <br /> If yes,describe access: <br /> Signature of Owner: <br /> Date: a 7 <br /> Signatnrc of Ow ner. Date: c <br /> 3 <br /> Uoeaparcelmeel Zoning Reyuirememi? _ _ )i• \'o - <br /> rc <br /> e : Uaea pmzrl require n.A,n'rP" 1'e.v U, u� / <br /> i /'et'trritnpplicntimrfeexsrrhmiited' / __ 11... rl5 �. Reeeipl9 <br /> ❑ Reconciles with Real Property'List er \'es \o Dale Ll�1�A1�- <br /> z <br /> •Iflafay.explain: 7 PC/� - ��'l�1 y�2•.�JB'lJ�'�.[r Z �Z'�Q�'1'd���/' "�d%4:�. <br /> � - t77-0/d-2-?sk -l5•lG•Z ol-ocn -�iliao . zoa .� :,, <br /> n <br /> Wb- N€-aW,' <br /> Applica ion: Approved Denied Reason for Denial: <br /> Land Elsee, Dale: <br /> 61 <br />