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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+$5.00/lot <br /> Owner: 'J�;XI�7P �h��Z <br /> Address: <br /> �TJ'CLd'J3�UY L( � Phone: <br /> Original Parcel Information A <br /> Parcel Identification#: ��-���3a-6/_'f ction , /3 L Township�6 Range /7 z <br /> Original Description(or attach copy): / / s 6 <br /> &4-Z tL <br /> $-no O <br /> Current Zoning: Floodplain Y/N: ?xyn ue -Fla.�Wetlands Y/N: <br /> A <br /> V• Lake/River Classification: (_IZ.5 Name of Water Body: Clam Fll�t-")eze'' <br /> m <br /> New Parcel Information <br /> N <br /> Proposed New Legal Description and Parcel Size: / <br /> V r 9 75- '76 <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided gN: <br /> If yes,describe access: <br /> L <br /> ➢ Does parcel meet Zoning Requirements? es No —EX iS �� �C -_—Stl <br /> N <br /> °e ➢ Does parcel require a Survey? es No e <br /> 3 <br /> ➢ Permit application fees submitted? Amount$ —26,00 Receipt <br /> A <br /> m XReconciles With Real Property Lister es No Date: <br /> 0 <br /> a � <br /> If not, explain: L <br /> a � <br /> i <br /> Application: pproved Denied Reason for Denial: c� <br /> (J <br /> Land Use: 3 Date: ^� q-Q 3 <br /> 2/18/2003 <br />