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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+$15.00/lot <br /> Owner: /-//x, STE✓�' (,t/icc2�cf/�M <br /> Address: ?;ew n //Ji E.tt✓A lLdR D <br /> � <br /> Vw..l�2 `/ ).JI _5 44i345' Phone: Cc e-L <br /> e% <br /> Orieinal Parcel Information 9 <br /> v <br /> Parcel Identification 3Z -S33*'d (See t�n l Township+Range 14P 0 <br /> Original Description (or attach copy): /JF f� _ /llF Y4- <br /> O <br /> y Current Zoning: A d Floodplain Wetlands <br /> o <br /> Lake/River Classification: Name of Water Body: <br /> m <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> Cn <br /> 01S/yl SfFcre Aa4-4?-� s <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> d <br /> Proposed access to public waters to be provided Y/N: <br /> If yes,describe access: 1 <br /> 0 <br /> 6 <br /> ➢ Does parcel meet Zoning Requirements? es No 9 <br /> N � <br /> ➢ Does parcel require a Survey? Yes No ° <br /> 3 <br /> 0o e <br /> ➢ Permit application fees submitted? ❑ Amount$ Receipt# <br /> at <br /> t- o <br /> e ❑ Reconciles With Real Property Lister Yes No Date: w <br /> a RU <br /> If not,explain: d1 <br /> o W <br /> w W <br /> O <br /> Applicatio : Approved// Denied Reason for Denial: <br /> 0 <br /> (' / G <br /> Land Use: Date: /� _< /moi_<� <br /> 2/18/2003 <br />