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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: J�?z -P7' / <br /> Address: aI'75 3 q _Te_Wr,'e_5 <br /> Iti d�yg`1�J Phone: 8�tv - yl 3- <br /> /, <br /> Original Parcel Information � / / <br /> Parcel Identification #: 2-HI-1 27 0 0391 Section 7 /Township I/A Range ��o VV 3 <br /> z <br /> Original Description (or attach copy): Ill VV Yq 5E So,4 4 o F <br /> (h; h«„a LAks 4vaa <br /> s <br /> y� o <br /> Current Zoning: /l23 FloodplainY Wetlands Y6 <br /> Lake/River Classification: Name of Water Body: <br /> d <br /> 0 <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: C S my a Q 3 " <br /> Acres: <br /> (if parcel is to be surveyed, provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: (1"Lt ve V a- U ..P_ <br /> Proposed access to public waters to be provided Y&. p <br /> If yes, describe access: b W y Q°t OR 2 <br /> ➢ Does parcel meet Zoning Requirements. Yes No ZONING c <br /> N <br /> °o ➢ Does parcel require a Survey Yes No n <br /> o <br /> 0° 3 <br /> ➢ Permit application fees submitted? Amount $ N�S'D� Receipt # S(09 cS <br /> ti <br /> Reconciles With Real Property Lister Yes No Date: a <br /> If not, explain: A' <br /> o <br /> -r <br /> a � <br /> N <br /> Applicatio �Approvedenied Reason for Denial: <br /> lu <br /> 1 <br /> Land Use: Date: " -2 ,U <br /> 2/18/2003 <br />