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Pre-application Consultation Form <br /> Wagner Surveying Associates, Inc. Request For Approval — Subdivision <br /> 26745 Lakeland Avenue NBurnett County Land Use/Zoning Department <br /> P.WO.isconsin Box 89 <br /> Webster ett County Government Center; Siren, Wisconsin <br /> , <br /> 715-866-429.5 p tv'Ver.� <br /> Applicant: J 11% f t'n lq va Owner: Nope RV 44.4-4r, C�Lp rc.l. <br /> 1001/ A6011 AV6'j. ( &L.C.4 5,. 11:041p, ) <br /> P/(,��7►+�IAr�,.v, /��n_ SS3 <br /> 431 7/ 2 pvvlla�,r( Aur S. A,Id <br /> Phone: toll' f11 -417z. Phone 012 - $GL 822 PASS-47% <br /> Original Parcel Information: <br /> ➢ Location of Property: G e v I `.1 I <br /> ➢ Section: IZ Township: 28 Range: Size: 4.rc,— <br /> ➢ Legal Description: 2 rlraCl.r S-ec rghcrl n'17/, (Z 'g;SY.'h1p4we/,J <br /> ➢ Current Zoning: R x I Floodplain/N: Wetlands/Y/JJ: <br /> New Parcel Information: <br /> ➢ Land Surveyor Preparing Plat/Map: <br /> ➢ Number of Lots: 2 Proposed Zoning: s/4 A c <br /> ➢ Regional Flood Elevation: ( IVIM., w1 <br /> ➢ Will Access to Navigable Body of Water be Provided/Available,A: <br /> ➢ Type of Access (Example: Outlot, Easement, Etc.): Lniy-c �•� <br /> ➢ Proposed Water and Sanitary System: P*'iy,af e <br /> ➢ Proposed Use: Residential: Commercial: Other: rnG <br /> y � ,....�� <br /> Date: bA��0 L Signature: Y NO M,7 <br /> C � <br /> For Office Use Only — Fees Collected: Z <br /> Date of Land Use Committee Preliminary Acceptance: Action: 9 <br /> Date of Land Use Committee Final Acceptance: Action: <br />