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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 /> SIREN, WI 54872 C <br /> APPLICANT: <br /> OWNER: BREAi7 F,Q16U,21v1Y <br /> 26745 Lak-ICnd Avo. N. 12730 OnbER �R <br /> Webster, WI 54893 1�po).e VgLCPv Mn- <br /> ------- <br /> aw 865.4291 <br /> Phone: Phone: 12- 423- (ogg9 <br /> Location of Property: C5nij LJ 2 <br /> Parcel No. <br /> Section 26 Township ! L) Range_ Size 2 <br /> Legal description attached. <br /> Names of Subdivision: C" Sy�!•1 <br /> Land Surveyor preparing plat: N A K V :8 E <br /> Number of Lots Z Current Zoning R n 1 Proposed Zoning L)? 1 <br /> Will a Planned Unit Development be required L- <br /> Proposed water supply P12 I v <br /> Proposed sewage system {L Iv Y <br /> Proposed uses: Residential X Commercial Park/Public <br /> Date q/ 93 Signature <br /> Fees Collected: <br /> Date of Land Use Committee preliminary acceptance <br /> Action <br /> Date of Land Use Committee final acceptance Action <br />