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=(mustany form): <br /> Burnett County Subdivision Permit Application rvey: 510.00 <br /> and/or Pre-Application Form vey:S100.00+$15.00/lot <br /> Owner: ` fl'go 1 1VASP• 9U0/- R� yv JArr <br /> Addressdoo0 61lH6 5090 /ilrn4 Lit RV73 8-4 <br /> 11 p SI l?r h I.f P1Nau''2Phone: <br /> l•J�l r.. <br /> b <br /> Original Parcel Information 0 <br /> 615-722o-6I400 � <br /> Parcel Identification#: s E N� Section 20 Township 3 Range _ <br /> Original Description (or attach copy): F NC C Iha 1 <br /> _796 -7s. � <br /> Current Zoning: V N 24,eA Floodplain Y/N: — Wetlands C <br /> Lake/River Classification: — Name of Water Body: <br /> o <br /> o - <br /> New Parcel Information <br /> 1 <br /> Proposed New Legal Description and Parcel Size: <br /> 0 <br /> Acres: 4.10 S <br /> 6' <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) j <br /> Proposed access to public road: ��A t7 <br /> Proposed access to public waters to be provided Y✓1�1 <br /> If yes,describe access: o <br /> t <br /> ➢ Does parcel meet Zoning Requiremen Yes No <br /> n <br /> N 3 <br /> °e ➢ Does parcel require a Survey? Yes No e <br /> e <br /> q ° <br /> vo <br /> ➢ Permit application fees submitted? � Amount$ ��5' � � Receipt# U S� <br /> 0 <br /> ❑ Reconciles With Real Property Lister Yes No Date: <br /> a RJ <br /> If not,explain: 9-1 <br /> 91 <br /> a t <br /> w d <br /> r <br /> Applicata �Approved nied Reason for Denial: <br /> O <br /> O <br /> Land Use <br /> Date: ���—�� <br /> 2/18/2003 <br />