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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 Subdivisionw/Survey: $25.00+$5.00/lot <br /> N <br /> Owner: 1 C IC j Q6)m N a kA>°1�-2. <br /> Address: _7668 Cou, " 4 leoacl U <br /> 10 Q fJ bU e_ 5 1$.36 Phone: 71-5 <br /> Original Parcel Information 'd <br /> A <br /> Parcel Identification #: MJ41'p'c Lo r6('tction Township yU Range <br /> 0 <br /> Original <br /> ADescription <br /> /(or attach copy): L Q - \ 2` 4,, <br /> 6 b� �c 7 ` I 8� (hent 01/1 Lu} / <br /> txr <br /> )I A,y r of <br /> yo[��. Lit,< nL,eJT <br /> y� O <br /> y Current Zoning: t` — Floodplain Y/N: U/1" Wetlands Y/N: � <br /> v <br /> �• Lake/River Classification: — Name of Water Body: <br /> m <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: � MQv-L4 Ct_.(, <br /> � uP Qddto 6�tj <br /> o 11 Pa4b -!J �MA <br /> cres: vl T <br /> (if parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 0UNtU k6 I <br /> Proposed access to public waters to be provided Y6) VYLO <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements? Yes No Od <br /> N <br /> V <br /> ' ➢ Does parcel require a Survey? Yes J No <br /> � `spn�tC fi �7 <br /> ➢ Permit application fees submitted? l P Amount $ 60,6D Receipt <br /> A <br /> 4t <br /> Reconciles with Real Property Lister Yes No Date: <br /> n <br /> If not, explain: <br /> o Q, <br /> a. I <br /> N A <br /> Application: Approved / Denied Reason for Denial: <br /> dV <br /> Land Use: ` I ` Date: <br /> 2/18/2003 <br />