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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:$100.00+$1 5.00/lot <br /> Owner: < Ei <br /> Address: 424e SRLc cNElz RD CoNracr: �N/t. �eN�� <br /> MADrSa,f L-✓ 6'3 --;Lo ¢ Phone: 7/s - ;-6z - /3SZ <br /> A <br /> Original Parcel Information 3 <br /> o3-ses os-604P <br /> Parcel Identification#: 63 -100 ` es'`.�iee Section 24- Township '31) Range it- o <br /> Original Description (or attach copy): TME Ti sta' o.✓ 7-410- 1611 <br /> O <br /> e <br /> Current Zoning: RVM l 2M'?- Floodplain YIN: �*/ Wetlands V �o <br /> 9• Lake/River Classification: ('64-55 3 Name of Water Body: '6*65 e,4/C tr' n <br /> o N$Dr✓/ ro .Gf 59 4 <br /> New Parcel Information c <br /> Proposed New Legal Description and Parcel Size: Z Go r C.5. Aek• /t5 5pr-e/Fir:)> <br /> an/ Ar T-,4 eH G AAAo'P S <br /> Acres: SEF_ M*V P <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: E k/s r ✓L G4SaEattiv r To t&r <br /> C7 <br /> Proposed access to public waters to be provided Y/N: /40 R <br /> If yes, describe access: <br /> 0 <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N o <br /> ➢ Does parcel require a Survey? Yes No e <br /> o e <br /> ➢ Permit application fees submitted? ❑ Amount$ 0 D 0 Receipt# SOLI V <br /> x <br /> o ❑ Reconciles With Real Property Lister Yes No Date: .wc ;1 <br /> CL ww w <br /> If not,explain: i r <br /> CL oa oc <br /> rn z w�W <br /> Applicatio . Approved Denied Reason for Denial: <br /> Land Use• � Date: <br /> 2/I8/2003 <br />