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Burnett County Subdivision Permit Application Fees(must accompany forth): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey:$100.00+$15.00/lot <br /> D{}tElACk ee- Dlr VCLo f(Ad krr (1C. <br /> Owner: 6fuCe ')CwkIMele<- <br /> Address: (i(013 SCcga;0. Zo .A <br /> d Ana / M 554-39 Phone: 15PL" q/ 2 - g325 <br /> A <br /> PAQT OF Original Parcel Information <br /> (9;2g - q126-0.3 . 000 Zs t <br /> Parcel Identification#: 4.2 B- 4 I ZS-o 1 7o?Sectii_on6 Township Range N o <br /> Original Description(or attach copy): `�ee .�!1VAItcl <br /> O <br /> 7 �/ f <br /> y Current Zoning: Tp R- / Floodplain YIN: /V 0 Wetlands Y/N.l:: <br /> Lake/River Classification: _CIa l Name of Water Body: <br /> m � <br /> j <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: -1-rt^ea a fur Aaned - Sec <br /> PARCEL lrD B6 SoLO 1J AD.roin162 T'o AfoeTN &6ell<h� G <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: C Q E kTE 3 6%-J 'Z�P-k X-Lj A Y <br /> d <br /> Proposed access to public waters to be provided Y/N: D <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> CT <br /> N e <br /> °e ➢ Does parcel require a Survey? Yes No 3 <br /> _ o <br /> ➢ Permit application fees submitted? ❑ Amount$ I`�` Receipt# <br /> u <br /> oo <br /> ❑ Reconciles With Real Property Lister Yes No Date: <br /> C6 <br /> If not,explain: <br /> e Ql )1 <br /> a UI G <br /> a 1 <br /> O o <br /> LU <br /> Application: A proved / Denied Reason for Denial: J o <br /> c o <br /> 00 <br /> Land Use: <br /> 2/18/2003 -- <br />