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Burnett County Subdivision Permit Application Fees(must accompany form): <br /> Subdivision w/o Survey: S10.00 <br /> and/or Pre-Application Form Subdivision w/Survey: $25.00+$5.00iiot <br /> Owner: A n.,xd L+n.-d�i Y' S\j en4r .e_ <br /> Address: a VttC( mac-,e L RA <br /> �rec��Y tG l�t�A, S4 3q Phone: 615) D1-1-437j <br /> Original Parcel Information A <br /> 3 <br /> Parcel Identification 07i`}' KilDiection 11 Township 3—Range k% <br /> Original Description(or attach copy): S vL/-f S'1 /R I f uJ So.cVtn PxS F 4�,ta•r�t� (�j <br /> CS;Y.k a� 1J! Y*) Ei4c eee *%L IJe� G1, Sot s <br /> b� <br /> Current Zoning: Floodplaing/N: WetlandsN: <br /> 0 <br /> A <br /> Lake/River Classification: <br /> 3 Name of Water Body: ,r\arwq& <br /> A parcel of property described se fellows:The North 336 feet of the Southeast <br /> Quarter of the Northeast Quarter(SE 1/4 NE 1/4),Section Twelve(12),Township t p C_KcU4 #_"4 e <br /> Tbirty-seven(37)North,Range Eighteen(18)Went,Except the North 132 feet of ori j <br /> the East 660 feet as previously conveyed by document No 338292. <br /> 12 <br /> The above described parcel is adjoining to and intended to be considered as a tAcres <br /> single parcel with the parcel described to Document No. 338292 which is not to be <br /> conveyed or used as an independent parcel. <br /> ".,Y....CA is to VC aurrryCU,tr.UTMW p.Cuuunary map. see attached for preliminary map requirements.) <br /> Proposed access to public road: Y\one re_ S t.'_.rtc/ <br /> Proposed access to public waters to be provided Y/N: N <br /> m <br /> A <br /> If yes,describe access. <br /> Al <br /> 4� <br /> ➢ Does parcel meet Zoning Requirements? Yes No <br /> N <br /> 'e ➢ Does parcel require a Survey? Yes No c <br /> 3 <br /> Permit application fees submitted? ❑ Amount,S Receipt# Do, <br /> A <br /> x <br /> El Reconciles With Real Property Li er Yes No Date: w <br /> Ca. <br /> If not,explain: <br /> c <br /> c <br /> Applicatio Approved Denied Reason for Denial: <br /> Da <br /> O <br /> O <br /> Land Use: � ✓! �-' Date: <br /> vtsn003 <br />