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Pre-application Consultation Form <br /> Request For Approval — Subdivision <br /> Burnett County Land Use/Zoning Department <br /> Burnett County Government Center; Siren, Wisconsin <br /> Applicant: .�e(/c Lnc�w�•Ur it�a, Owner: / to e;ts�C�ris %1cc �► �,� <br /> Phone: 3aO Phone: <br /> Original Parcel Information: , /! <br /> ➢ Location of Property: On C1�„ Ifel ,� /� ,,,,4- nci-f/ a <br /> ➢ Section: 33 Township: Range: Size: /0 a` <br /> ➢ Legal Description: lea/ SVl%Y -NW/4 l A/ <br /> ➢ Current Zoning: (/n z,,,ec l Floodplain YIN: // Wetlands YIN.- X <br /> New Parcel Information: <br /> ➢ Land Surveyor Preparing Plat/Map: <br /> ➢ Number of Lots: Proposed Zoning: <br /> ➢ Regional Flood Elevation: <br /> ➢ Will Access to Navigable Body of Water be Provided/Available, YIN: "Itlo <br /> ➢ Type of Access (Example: Outlot, Easement, Etc.): (�:06 ,e9 <br /> ➢ Proposed Water and Sanitary System: Vaw &ndl �= <br /> ➢ Proposed Use: Residential: x Commercial: Other: <br /> r4 in, <br /> 6> <br /> g � ,... 1 <br /> Date: 7 O� nature: O <br /> Si <br /> For Office Use Only — Fees Collected: J ;� <br /> Date of Land Use Committee Preliminary Acceptance: d _ Action: <br /> Date of Land Use Committee Final Acceptance: Action: <br />