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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> and/or <br /> lPre-Application Form Subdivision w/Survey: $25.00+$5.00not <br /> Owner: �1d� Ae►`-C' A l5 '\ �� L4" � S <br /> Address: PAUYVt Phone: <br /> Original Parcel Information <br /> r� 3 <br /> Parcel Identi£cation#: 6'� Section 3 (� Township Range <br /> z <br /> S si✓i�x N33d3s- <br /> Original Description (or attach copy): lo� %r�� y <br /> W3 1fd <br /> ' o <br /> q Current Zoning: a �, Floodplain 1V Wetland 4 <br /> g Lake/River Classification: , <br /> �� Name of Water Body: /l1 �-- <br /> m <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: C S� /n/WJ <br /> �— / I <br /> -f,�-Y/> �S�l V Iq P �� �(Ol')—1 Acres: j5 •� <br /> I <br /> 0,Sam G s in <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: CS M <br /> Proposed access to public waters to be provided Y N O <br /> A <br /> If yes,describe access: �( <br /> I <br /> ➢ Does parcel meet Zoning Requirements? Yes No a <br /> e ➢ Does parcel require a Survey? Yes /l No (-r*J I A <br /> ➢ Permit application fees submitted? Amount$ Receipt # ( °e <br /> xc <br /> a ❑ Reconciles With Real Property Lister es No Date: 3 q <br /> 6 <br /> If not,explain: <br /> v. W <br /> Application: Approved Denied Reason for Denial: <br /> -a �3 <br /> Land Use: Date 7 V <br /> 2/18/2003 <br />