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cx s <br /> t' Date Filed <br /> PREAPPLICATION CONSULTATION FORM <br /> REQUEST FOR APPROVAL - SUBDIVISION <br /> BURNETT LAND USE DEPARTMENT, BURNETT COUNTY GOVERNMENT CENTER <br /> SIREN, WI 54872 <br /> APPLICANT: bA/y96N� ' OWNER: SSo/liS <br /> Soy f/,Cm,�oiuD <br /> ltiF✓3si�� y�//. /e/CE 1,4/CE !A✓/ <br /> Phone: 8lrl�C� - 07 -q217:-�— 1 Phone: <br /> Location of Property: GOt/E1Pil/ii4jEA77- 07- <br /> —7 Parcel No. <br /> Section / Township Ranger Site 37 Oo0 S,F, <br /> Legal description attached. <br /> Names of Subdivision: <br /> Land Surveyor preparing plat: -,"Wx,,'C �Rs4Gf�� <br /> Number of Lots Current Zo i g / Proposed Zoning <br /> Will a Planned Unit Development be require V0 <br /> Proposed water supply 7' RIll,.IqL� <br /> Proposed sewage system {OR11147- _ <br /> Proposed uses: Residential_ Commercial Park/Public <br /> Date Signature <br /> Fees Collected: <br /> Date of Land Use Committee preliminary acceptance Action <br /> Date of Land Use Committee final acceptance Action <br /> .. .... .. . . .. -' ... t '.ea+rN. <br />