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t3if Un/; lUdb U'J:29 3492166 B C ZONING PAGE 01 <br /> Burnett County Subdivision Permit Application Fees(must eceompsoyf0tm): <br /> and/or Pre-A llcation FSubdivisimw/o Survey, SIo.no <br /> PP • Form Subdivisionw/Survcy:S100.00+f15.00Aot <br /> y <br /> Owner: 1 h J OA a5 c- lt�r 1G rt 4j cG� <br /> Address: <br /> Phone: <br /> v <br /> Orieinal Parcel Information <br /> �L —¢23G 'G �¢cr <br /> Parcel Identification — —c+5' t. Section 547 Township 4c' N Range f5 i4 e <br /> Original Description (or attach copy): ScE A i/l Gj/E� DE�t7� <br /> 6` <br /> O <br /> a <br /> Current Zonin d <br /> 9 R Floodplain Y/N: Wetlands Y/N. <br /> Lake/River Classification: , // ! ^zo <br /> Name of Water Body: /VO2— / SCJ Li¢/� <br /> 0 F <br /> 07- <br /> New <br /> New Pareel Information � o <br /> s <br /> Proposed New Legal Description and Parcel Size: _3t=E <br /> �ro <br /> S � <br /> Acres• S <br /> S <br /> A <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) � <br /> Proposed access to public road: V S ;/ti'G /�i�/✓if i /�c,bpN�~S`�'4 <br /> Proposed access to public waters to be provided Y/N: YEs <br /> If yes,describe acceaa: 4c_lk t s TiN G Sryn L/N c �C�S e <br /> > Does parcel meet Zoning Requirements? yes No � <br /> w. > Does parcel require a Survey? yes No e <br /> > Permit application fees submitted,1 p <br /> Amount$ Receipt# r <br /> A <br /> ❑ Reconciles With Real Property Lister Yes No oO <br /> Date: V <br /> U not,explain: <br /> � WW <br /> EM (7101 <br /> 6'6 <br /> Applies 'on: Approved / De led Reason for Denial: zz <br /> �o <br /> �a o <br /> Land Use: Date: <br /> 2/1&2003 <br />