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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+$5.00/lot <br /> Owner: Doju/I l(l(tftLQ) <br /> Address: !U I� �� U� 111an7S- <br /> a 9'95 / & at & al Phone: Es7 <br /> t S <br /> OriOnal Parcel Information b <br /> A <br /> aa- �-� /( 3 <br /> Parcel Identification#: 0 3a a-S�� S�e�ion �a- Township �� Range �* <br /> q z <br /> Original Description (or attach copy): <br /> Pr -scs tv / <br /> 0 <br /> Current Zoning: IC )C - 3 Floodplain Wetlands /N: Al <br /> Lake/River Classification: Name of Water Body: _ <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> L / cL-h d LA CSM <br /> Acres: 4)- /3 ead, <br /> G <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements..)- tzy <br /> Proposed access to public road: %1T 3S_b ul <br /> m a <br /> Proposed access to public waters to be provided /N: A <br /> If yes,describe access: '�ZQ�-•tJ � <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N <br /> e ➢ Does parcel require a Survey? ^/ Yes No c <br /> r}{ , ! D <br /> ➢ Permit application fees submitted? ty�•Y- Amount$ Receipt# <br /> A <br /> u <br /> Reconciles With Real Property Lister Yes No Date: o <br /> a � <br /> A° If not,explain: 5u <br /> n i � <br /> o BW!1 <br /> a � <br /> h ^ , <br /> Application: Approved / Denied Reason for Denial: `SPP Uel. p a� Vj/ <br /> Land Use: ( � )/ Date: /'OV-6 <br /> 2/18/2003 <br />