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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: >Cl,r.n o K 1141 r_g -St-Pworr <br /> Address: 24 I LFy WA'-g6 PN <br /> Phone: 34 ct frc, z3 <br /> Original Parcel Information <br /> 10- <br /> 07 a <br /> —3335= <br /> Parcel Identification#: Ot Section 35 Township 3� ST Range i h z <br /> 0 <br /> Original Description (or attach copy): 1_o+- z , c Z u, o ec . _ c s, f�L 3 s 7 G W <br /> \Im. 08 P• ( 5 -/k J <br /> O <br /> Current Zoning: N q Floodplain YO ,5 n Wetlands YQT J,(--) <br /> 0 <br /> A <br /> Lake/River Classification: Name of Water Body: <br /> m <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: 1 j e a t cra I�.+ 12.!d cs m <br /> v <br /> Cs m �1 CIS <br /> Acres: <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: F,,4,,4 <br /> Proposed access to public waters to be provided Y/N: kb m <br /> A <br /> If yes, describe access: W <br /> ➢ Does parcel meet Zoning Requirements? Yes j No <br /> N <br /> °o ➢ Does parcel require a Survey? Yes No 0 <br /> o'a � <br /> ➢ Permit application fees submitted? Amount S /J�L • 6D Receipt# a <br /> w <br /> A <br /> Reconciles With Real Property Lister Yes No Date: <br /> a <br /> If not,explain: <br /> o W <br /> a W <br /> y <br /> Application Approved enied Reason for Denial: d <br /> i <br /> c <br /> G <br /> Land Use: Date: S _4��y <br /> 2/18/2003 <br />