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Date Filed <br /> PREAPPLICATION CONSULTATION FORM <br /> REQUEST FOR APPROVAL — SUBDIVISION <br /> BURNETT LAND USE DEPARTMENT, BURNETT COUNTY GOVERNMENT CENTER <br /> WI <br /> 72 <br /> APPLICANT: <br /> OWNER: SIZ&VT ��%fa✓ rlivtl <br /> 26745 Lakolcnd Avo. N. 1 2 36 DovFR DR <br /> Webster, WI 54893 APO)? VA[.,Py Inn <br /> (7151 B5F "�° <br /> Phone: Phone: <br /> Location of Property: L,t 2 <br /> Parcel No. <br /> Township )S Size 2 <br /> Section 2,� p 4o Range <br /> Legal description attached. <br /> Names of Subdivision: G• S v <br /> Land Surveyor preparing plat: m ink �12AySr <br /> Number of Lots.? Current Zoning Proposed Zoning <br /> Will a Planned Unit Development be required <br /> Proposed water supply P12iv <br /> Proposed sewage system <br /> Proposed uses: Residential X Commercial <br /> Park/Public <br /> Date 1Z 2 Signature i <br /> Fees Collected: <br /> Date of Land Use Committee preliminary acceptance <br /> Action <br /> Date of Land Use Committee final acceptance <br /> Action <br />