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rre-appiication t onsuitation corm <br /> Request For Approval— Subdivision <br /> Burnett County Land Use/Zoning Department <br /> Burnett County Government Center; Siren, Wisconsin <br /> Applicant: Owner: ROtt C. sE/�a ,TR <br /> Wagner Surveying wssac!a<< s, !:,: <br /> 26745 Lakeland avenue N. C c C jeo,gp <br /> Box <br /> Webster, Wisconsin 5489" V I?Aff un y 6yts S¢ ;a <br /> Phone: Phone: g 6 6. 7B8Z <br /> Original Parcel Information: <br /> ➢ Location of Property: G L 3 °} �SW SE Scc ZC <br /> ➢ Section: 7S Township: ¢/ Range: (. Size: Z 7Ac+• <br /> ➢ Legal Description: <br /> Current Zoning: 3 Floodplain Y/ Wetlands <br /> New Parcel Information: <br /> ' ➢ Land Surveyor Preparing Plat/Map: b RK fav s E <br /> ➢ Number of Lots: .r Proposed Zoning: SO e <br /> ➢ Regional Flood Elevation: ALTA <br /> ➢ Will Access to Navigable Body of Water be Provided/Available, Y,® <br /> ➢ Type of Access (Example: Outlot, Easement, Etc.): — <br /> ➢ Proposed Water and Sanitary System: fe-�'V r/t <br /> ➢ Proposed Use: Residential: �_ Commercial: Other: <br /> Date: bZ18'10 2 _ Signature: <br /> For Office Use Only — Fees Collected: <br /> Date of Land Use Committee Preliminary Acceptance: Ittizo <br /> on. <br /> Date of Land Use Committee Final Acceptance: 1 1 n: <br />