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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 /> Applicant: Owner: Pau t- TkA V wkle <br /> iat , ,111. <br /> 26745 Lakeland Avenue N. 136Y amble- �'64 61 <br /> Webster, Wisconsin 54863 , �'`f n Jmz <br /> 715-866-42,e,5 ff <br /> Phone: Phone: ,0,39— -39 y9 <br /> Original Parcel Information: <br /> ➢ Location of Property: R o 0 N Cr Uq 12 < <br /> 6.L• y Suez <br /> ➢ Section:-� Township: r'/D Al Range: 06 Size: Cie—A&$ <br /> ➢ Legal Description: L `'/ -�e4 l Z- C•L / �- 13 <br /> ➢ Current Zoning: R 2 Floodplail&. Wetland• <br /> C+LASJ 3 <br /> New Parcel Information: <br /> ➢ Land Surveyor Preparing Plat/Map: > c-K /�iLGtS-2� e <br /> ➢ Number of Lots: Proposed Zoning: J'M c <br /> Regional Flood Elevation: V N Ot ww �� 6 <br /> O <br /> ➢ Will Access to Navigable Body of Water be Provided/Available, Y(5) �2p�qzo <br /> ➢ Type of Access (Example: Outlot, Easement, Etc): c% <br /> Pr; <br /> ,t <br /> ➢ Proposed Water and Sanitary System: Pri va I ,0 exit('h0 <br /> ➢ Proposed Use: Residential: x Commercial: Other: <br /> Date: I l A6 I Signature: VA4� �_ n w <br /> For Office Use Only — Fees Collected: <br /> nn �,�( a -3•-dl <br /> Date of Land Use Committee Preliminary Acceptance: '1 Action: <br /> Date of Land Use Committee Final Acceptance: Action: <br />