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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+$5.00/lot <br /> �/ <br /> Owner: GREG 04A.SOh (,14A7Joti �it��tsrr.ye� <br /> Address: nn .3/42.3 Mrt4bl, R.40(0( <br /> &IV9&9y Is Phone: b//Sbl-7-I 79 <br /> 32 -52�D -C01900� OriOnal Parcel Information <br /> Parcel Identification #: 61800 b3Qoo section JS Township / Range 3' <br /> �+ 1 0 <br /> Original Description <br /> es ription (or attach copy): aJ~ f oy( z-ay &CAA W <br /> ghd SEN ►v <br /> 0 <br /> 0 <br /> y Current Zoning: R 2 Floodplain Y/N: WetlandoN: <br /> Lake/River Classification: — Name of Water Body: <br /> iu g <br /> s <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: _ Couhtl$flpr 2.14e - <br /> 3A � 7z) <br /> U. <br /> UN <br /> Acres: <br /> (if parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: SA-WA <br /> Proposed access to public waters to be provided Y ' v <br /> m <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements? )'es No <br /> N <br /> ➢ Does parcel require a Survey? )'es No (� <br /> °0 9 n 3 <br /> ➢ Permit application fees submitted? Amourt! $ /�. Receipt # /a7N e <br /> i W <br /> a g� <br /> ❑ Reconciles With Real Property Lister Yes No Date: C <br /> X If not, explain: iL <br /> o � <br /> ca <br /> u o <br /> Applicatio Approve / Denied Reason for Denial: � <br /> � 8 <br /> Land Use: ZOyL1M Date: <br /> c ' <br /> 2/18/2003 <br />