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Pre-application Consultation Form <br /> Request For Approval— Subdivision <br /> Burnett County Land Use/Zoning Department <br /> Burnett County Government Center; Siren, Wisconsin <br /> Applicant: MlgnmrOwner: )Ye- <br /> 26745 <br /> 'e26745 Lakeland Avenue N. <br /> P Zf n anv RQ I 4eCuXet- Cosoki <br /> Webster, Wisconsin 54893 <br /> 715-866-12-9-5. <br /> Phone: Phone: k/ 6S/ -264 -7395 <br /> Original Parcel Information: <br /> ➢ Location of Property: G L s E k t.fT l NL 12Akt r l) <br /> ➢ Section: 3Township: yD k Range: 15UJ Size: / -7/ d0-e,-'9 <br /> ➢ Legal Description: <br /> ➢ Current Zoning: I Floodplain 6k. Wetlandso.- <br /> New Parcel Information: <br /> ➢ Land Surveyor Preparing Plat/Map: t 'I CL2/e eetuG 5c- <br /> > <br /> t-➢ Number of Lots: ' A / Proposed Zoning: T17- r< <br /> ➢ Regional Flood Elevation: /V ov i4 SAAA* I-4h. <br /> ➢ Will Access to Navigable Body of Water be Provided/Available- <br /> ➢ Type of Access (Example: Outlot, Easement, Etc): tgh, Car <br /> ➢ Proposed Water and Sanitary System: 6"4 11 h* �r.�a/e <br /> ➢ Proposed Use: Residential: '� Commercial: Other: <br /> Date: �a/IS Signature: "W4.44..I. <br /> For Office Use Only — Fees Collected: <br /> a Date of Land Use Committee Preliminary Acceptance: Action: <br /> Date of Land Use Committee Final Acceptance: Action: <br />