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poet(mutt accompany fam): <br /> Burnett County Subdivision Permit Application Subdivision w/oSurwy. $so.00 <br /> and/or Pre-A Pre-Application Form St""ryofExLu'^ep0100t: sso.o()&A <br /> PP Subdivisionw/Servev: s200.00+s50.0ana <br /> ��4 rL. f�aTt/i iV <br /> Owner. Buyer: �Jn <br /> Address: t7 D ZfK e,D• Address: <br /> l S�87Z <br /> •✓OT A-AJ6 I ) <br /> Phone: Phone: <br /> T"X' <br /> xb NO Qri�Fnal.Parcellnformation <br /> 2537 <br /> ParcollDq: __ TX S4 /"x Sectlon Z,j Township 38 Range <br /> Original Description(or attach copy): NG 'S L✓ �X CP _ 3s0 <br /> zVA)n TI{fr 2V✓() 516 eX C' f �'S 1 �?.54- Qt <br /> r Cta-rent Zoning: fi-0 Floodplain Y/N:�_Wetlands Y/N: Lalte/River Class:, = <br /> m Nwase of Water Body: /J Shoreland Agmemeat/SIPS Y/N: AJ ( — <br /> ~ F,trulaad Preservation YIN: A/ Managed Forestry Law Y/N:� N !� <br /> P1ewPzt.cd information //cxe a}}c. kV& Ske�c�t <br /> Proposed New Legal Description and Parcel Size: <br /> �,peG/AL �Pl�fkJ ��2 .�YAl�I7'[�✓FLp��y]�I�T� <br /> Acres: <br /> (If parcel is to be surveyed,provkle preliminary map. See attached for prelloduary map requirementi.) <br /> Proposed access to public road: P S (�) f2 CZ, r2—'7 d <br /> Proposed access to public waters to be provided Y/N: IV / <br /> ?61 If yes,describe access: <br /> Siggr adore orOwner: Bate: <br /> Signature of Owner. Date: <br /> m <br /> Y Does parcel meal Zoning Requirements? Yet No <br /> Does parcel require a Survey? Yes No v <br /> °O A Pernilt application fees submltled? ❑ Amount$ Rece7n 4 <br /> ❑Reconciles with Ileal Property Lister Ycs No Date: <br /> UJ <br /> a. If not,explain: _ <br /> S1J, <br /> p W <br /> E <br /> eC4' <br /> le it �eoso,t -(;:i,otM P�vl7 �` <br /> ECEWE � `)� <br /> 0. <br /> VR -7 <br /> BURNM COUNTY <br /> ZONING <br />