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Date Filed g7 <br /> PREAPPLICATION CONSULTATION FORM <br /> REQUEST FOR APPROVAL - SUBDIVISION <br /> BURNETT LAND USE DEPARTMENT, BURNETT COUNTY GOVERNMENT CENTER <br /> SIREN, WI 54872 <br /> APPLICANT: oln4j- Sc,,Ei✓foOWNER: 99"' 01A11,1,- 6ci,q <br /> t / ecx z98 9 c- . r-' hA4 <br /> Phone: .39 Z S93 Phone: 8&& <br /> Location of Property: 6—le i SCC -3 <br /> Parcel No. <br /> Section 3 Township -a Range Size J5- A i <br /> Legal description attached. Nc <br /> Names of Subdivision: /tiG- / <br /> Land Surveyor preparing plat: inA-S SGa�>✓S'on/ <br /> Number of Lots 3 Current Zoning S Proposed Zoning <br /> Will a Planned Unit Development be required lVv <br /> Proposed water supply <br /> Proposed sewage system �iria/tT� <br /> Proposed uses: Residential-7X Commercial Park/Public <br /> Date Signature <br /> Fees Collected: <br /> r � <br /> Date of Land Use Committee preliminary acceptance a Action / <br /> Date of Land Use Committee final acceptance Action <br />