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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: $25.00+$5.0011ot <br /> Owner: d -y— <br /> akL i Ohl GLC�/� "G�e/� i>[/ <br /> Address: 3801 <br /> OLID �Jl Phone: <br /> , 9* <br /> Original Parcel Information <br /> , <br /> G / // 3 <br /> Parcel Identification #: A14— <br /> j 14-4/1QJd(,6fy Section 8 Township VeW Range <br /> PCL z <br /> Original Description (or attach copy): T <br /> (� Q/� L!1 � <br /> 5C 8-y V Z(a9 P 32 v,71//15 <br /> 0 <br /> Current Zoning: Floodplain Y ; Wetlands <br /> Ye61 <br /> Lake/River Classification: Z Name of Water Body: <br /> 4 <br /> New Parcel Information 1 <br /> Proposed New Legal Description and Parcel Size: <br /> Acres: 1 <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: J" <br /> Proposed access to public waters to be provided Y� v <br /> A <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements? 1'es No <br /> N <br /> °e ➢ Does parcel require a Survey? Yes No f1 <br /> 0 <br /> w 3 <br /> ➢ permit application fees submitted? ❑ Amount $ Receipt # °e <br /> A <br /> x <br /> ❑ Reconciles With Real Property Lister Yes No Date: orl <br /> � <br /> a R1 <br /> oIf not, explain: <br /> a O <br /> i <br /> O <br /> Applicatio Approved Denied Reason for Denial: <br /> Land Use: Date: <br /> 2/18/2003 <br />