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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+$5.00/lot <br /> Owner: Mlichoi1 Wc, 1lr F_� gi <br /> Address: 59 , 0 i .H S+rte r E .i <br /> Arlinoau � .JR 77 -L Phone: _7053-2 <br /> Original Parcel Information T� <br /> 3 <br /> Parcel Identification #: ov z -p ,5 is-a 2,v,) Section Z 5 Township 38 Range i g <br /> 0 <br /> Original Description (or attach copy): 6 L�v 3 w;+, 2 , er�•us u�c p�t. , _ <br /> see far ro ( t J <br /> G <br /> O <br /> O <br /> y Current Zoning: A -Z Floodplain Y/N: rJ Wetlands Y/N: J <br /> o � <br /> ,9--,• Lake/River Classification: Name of Water Body: <br /> m <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: Cbt L of / fezt'Fed Lr"V Moo <br /> 5� <br /> Acres Jf. No +� <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) — <br /> Proposed access to public road: <br /> Proposed access to public waters to be provided Y/N: d <br /> m <br /> A <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements.PC Yes No 6 <br /> ➢ Does parcel require a Survey? Ye - No f1 <br /> o <br /> ao g <br /> ➢ Permit applicationjeessubmitted? ❑ Amount$ (5� w Receipt # 9a4? °c <br /> A <br /> at <br /> ❑ Reconciles With Real Property Lister Yes No Date: g <br /> a <br /> If not, explain: � <br /> o � <br /> a q� <br /> N UI <br /> Q <br /> Application: proved / enied Reason for Denial: aj <br /> 0 <br /> Land Use: Date: <br /> 2/18/2003 <br />