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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: $10.00 <br /> and/or Pre-Application Form Subdivision w/Survey:S100.00+sumnot <br /> Owner: Tr¢r tCs <br /> Address: z-52>77 L�e�,yro/Li✓ p/z/✓c <br /> S tzE� S¢e77 Phone: <br /> A <br /> Orieinal Parcel Information �Qet,VAi 9 <br /> Parcel Identification#: ott3-3334--e`3- Section 34 Township _Range / � o <br /> Original Description (or attach copy): 5 /�2 , 5 lz /� E '/4 l(V-1 %4 lc� <br /> J <br /> O <br /> q Current Zoniug: �. Floodplain Y/N: IJ Wetlands Y/N: <br /> s r ` <br /> m Lake/River Classification: Name of Water Body: — <br /> LA <br /> New Parcel Information ( ) <br /> Proposed New Legal Description and Parcel Size: 3 07- - S .tM <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: ��5 <br /> O <br /> Proposed access to public waters to be provided Y/N: S <br /> If yes,describe access: 4 <br /> ➢ Does parcel meet Zoning Requirements Yes No <br /> N n <br /> e° ➢ Does parcel require a Survey? Yes No °g <br /> w e <br /> ➢ Permit application,fees submitted? ❑ Amount$ Receipt# <br /> u <br /> r <br /> e ❑ Reconciles With Real Property Lister Yes No Date: G19a <br /> R If not,explain: <br /> a <br /> u <br /> 1 <br /> Applicati Approved / enied Reason for Denial: t i <br /> O <br /> Land Use: Date: <br /> 2/18/2003 <br />