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Pre-application Consultation Form <br /> Request For Approval — Subdivision <br /> Burnett County Land Use/Zoning Department <br /> Burnett County Government Center; Siren, Wisconsin <br /> Mbikr <br /> Applicant: Wagn�yina Associates, Inc. Owner: ow_c tl 'Ltad'� (CM140 <br /> 26745 Lakeland Avenue N. <br /> P.O. Box 89 77M SANp L4kcgot4 <br /> Webster, Wisconsin 54893 <br /> 715-866-4295 <br /> Phone: Phone: 4go, L? (S <br /> Original Parcel Information: <br /> ➢ Location of Property: 1-&JZR - <br /> ➢ Section: Township: Al Range: /J5 VV Size: <br /> ➢ Legal Description:: Q_. / dLc— ? `3 7_1/( /V e /5 L'l �1-j6 '5-6,t9 7-Gv <br /> ➢ Current Zoning: pt`pI Floodplain: WetlandsoN: <br /> GLAss I &JANn <br /> New Parcel Information: <br /> ➢ Land Surveyor Preparing Plat/Map: d 2 k t kdJJ Q_k_, <br /> ➢ Number of Lots: Proposed Zoning: <br /> ➢ Regional Flood Elevation: <br /> ➢ Will Access to Navigable Body of Water be Provided/Available, Fri <br /> — �� <br /> ➢ Type of Access (Example: Outlot, Easement, Etc.): LA/k, �.•F <br /> 7 2002 <br /> ➢ Proposed Water and Sanitary System: Pk I v is 1t <br /> BURNETT-COUNTY <br /> ➢ Proposed Use: Residential: ✓ Commercial: Other: ZONING <br /> Date: U2 Signature: �//I�A•�f+� L �� <br /> For Office Use Only — Fees Collected: <br /> Date of Land Use Committee PreliminaryAcceptance: r1��a` Action., fir <br /> Date of Land Use Committee Final Acceptance: Action: <br />