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Burnett County Subdivision Permit Application Fees(must accompany forth): <br /> and/or Pre-Application Form Subdivision w/o Survey: $10.00 <br /> PP Subdivision w/Survey:$100.00+$I5.00l1ot <br /> Owner: <br /> Address: <br /> if 0C _E�S IO 0(,T (Q!a b l Phone: <br /> A <br /> Orieinal Parcel Information 3 <br /> Parcel Identification#: 090 _413002-OS`-6 LYSection 9' Township 'c&) Range e <br /> Original Description (or attach copy): G L ,S <br /> s <br /> J <br /> O <br /> > Current Zoning: Floodplain Y/N: Wetlands Y/N: <br /> �• Lake/River Classification: Name of Water Body: c <br /> m ^, <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: e.,5/n "I 5-3— (1, aD o7 p <br /> re <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: <br /> 0 <br /> 4 <br /> ➢ Does parcel meet Zoning Requirements? Yes No (J1 <br /> N f1 <br /> ➢ Does parcel require a Survey? Yes No °g <br /> ao 0 <br /> ➢ Permit application fees submitted? ❑ Amount$ Receipt# <br /> x <br /> ❑ Reconciles With Real Property Lister Yes No Date: 4� <br /> a o <br /> If not,explain: <br /> CL <br /> $ a <br /> N <br /> I <br /> CS <br /> Application: Approved / Denied Reason for Denial: <br /> 0 <br /> 0 <br /> Land Use: Date: <br /> 2/18/2003 <br />