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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: �OhEf'tQ(All(,+l'NI �Z //�•/ <br /> Address: �Ay13� �-XGee �OIJS C/r� /�����1/ �'/Z//e ���Ozld7`-/ <br /> Phone <br /> 018'3 3zj,�7–//9�6D cl/l&p Original Parcel Information <br /> 019-33z/10 -0970 a0y _ / 3 <br /> Parcel Identification #: Section z6 Township 3qW Range J/oW <br /> Original Description (or attach copy): Nyy �'/ �� — /t/� �y s� Yv p <br /> EX I S�) r i, P4 h Ct �� D d � 1 9s �9 44 Vile, r _Tlb a_ <br /> b $S P 31 ¢q?//J67�>>a���� ✓�¢SO s°7 —F <br /> oCurrent Zoning: FloodplairOY N: Wetlands N: <br /> C �.V <br /> �• Lakver lassification: ? Name of Water Body: <br /> co New Parcel Information <br /> Proposed New Legal Description and Parcel Size: CSM <br /> Acres: �. I <br /> (If parcel is to be surveyed, provide preliminary map. See <br /> attached for preliminary map requirements.) <br /> Proposed access to public road: ►-I rj2 &/YL , <br /> Proposed access to public waters to be provided6�V: p <br /> If yes, describe access: �r vtz, 1 of <br /> ➢ Does parcel nree!Zoning Requirenre+s Yes"� No G� <br /> 5 ➢ Does parcel require a Survey? )'es No n <br /> �• o <br /> oa 3 <br /> ➢ permit application fees submitted? ❑ Amount $ Receipt # <br /> A <br /> r ?f <br /> ❑ Reconciles With Real Property Lister Yes No Date: o p <br /> a - <br /> �° If not, explain: W N <br /> o (N <br /> w <br /> Application: pproved ' Denied Reason for Denial: �O <br /> Land Use: , Date: <br /> 2/18/2003 <br />