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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+$5.00/lot <br /> Owner: 966 8oe© 77 ehe-*-- <br /> Address: 3q3 Or-ee kyje)'o (U' <br /> n/, UJ1 002- Phone: 7�J-/Ob15 - �gO� <br /> Original Parcel Information <br /> I Dt7 �9N Flo IN 3 <br /> Parcel Identification#: U 1 S' 332 5- 10) Section o�:J Township Range ' <br /> z <br /> Original Description (or attach copy): <br /> O <br /> Current Zoning: lA ZO 1JY <br /> Floodplai>t� c j Wetlands_ Yrr- <br /> Lake/River Classification: Name of Water Body: L <br /> V c.tZsv <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: 0_ /YM <br /> Acres: 74. 57 t <br /> (If parcel is to be surveyed,provide preliminary map. See attached preliminary map requirements.) <br /> mi <br /> Proposed access to public road: / e2.�.56 A/ e a d <br /> Proposed access to public waters to be provided Y p <br /> d <br /> If yes, describe access: <br /> ➢ Does parcel meet Zoning Requirements? Y No <br /> N <br /> °o ➢ Does parcel require a Survey? No n <br /> °O 3 <br /> ➢ Permit application fees submitted? Amount$ Receipt# o� �a-- <br /> A <br /> r, zt <br /> Reconciles With Real Property,Lister es No Date: <br /> 06a <br /> If not, explain: <br /> 0 <br /> a � <br /> t/1 <br /> Application Approve / Denied Reason for Denial: (�jl <br /> O <br /> Land Use: ^'t Date: <br /> 2/18/2003 <br />