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Date Filed <br /> l PREAPPLICATION CONSULTATION FORM <br /> REQUEST FOR APPROVAL - SUBDIVISION <br /> BURNETT LAND USE DEPARTMENT, BURNETT 70UNTY GOVERNMENT CENTER <br /> SIREN <br /> WI <br /> APPLICANT: l/1��'iCN��SGlKI�� �f OWNER: <br /> �n�f�sr ie MLI . 983 8u-r�� �K .22-_ <br /> Gni/ _ ��95 �n„ �v�.p•i j�/l .��1830 <br /> Phone: Phone: �Jr6 —S710 <br /> Location of Property: GL <br /> Parcel No. <br /> Section Township Range_ SizeZ 2 <br /> � ! Legal description attached. <br /> Names of Subdivision: <br /> 1711 <br /> irn n <br /> Land Surveyor preparing plat: iiir�/J�y„ <br /> L ' - <br /> I <br /> Number of Lots Current Zoning '/�/�' posed Zoning/ P <br /> Will a Planned Unit Development be required ALQ <br /> i <br /> Proposed water supply <br /> Proposed sewage system <br /> Proposed uses: Residential_ Commercial Park/Public <br /> gill I Irl,� <br /> Da _7/te Signature <br /> Fees Collected: <br /> Date of Land Use Committee preliminary acceptance <br /> Action <br /> Date of Land Use Committee final acceptance <br /> Action <br /> i <br /> I <br />