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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+$5.00Aot <br /> Owner: �'rt TSL/ /oR - �.f7 1�L11 <br /> Address: 6536 �// n �/1211M /V <br /> I.S/� G✓/�, !/yl �D 9 Phone: ���T 4lp�- '11.31 <br /> Original Parcel Information A <br /> Parcel Identification M Section 17 Township�Range X74/ <br /> Original Description (or attach copyj L2- OF 0:5 M -�f- 0�7Z � •. <br /> V f 9 32 - 33 6-41 " <br /> P <br /> o <br /> Current Zoning: �C / Frloodplailmx: Wetl�a, ds/Y` : <br /> g Lake/River Classification: / Name of Water Body: /tl/ u neAlla Ire. , <br /> New Parcel Information <br /> Proposed New Legal Description and Parcel Size: <br /> - Cs� VM P12j l z <br /> /i <br /> 1 <br /> eCU-5/7) /V7 .3 Z-0-�-5 Acres: 9 99 t MLO <br /> (If parcel is to be surveyed,provide preliminary map. See attached for preliminary map requirements.) <br /> Proposed access to public road: 5 <br /> Proposed access to public waters <br /> //tto be provided: p <br /> If yes,describe access: La-Ale- LD n <br /> ➢ Does parcel meet Zoning Requirements? Yes No RJB <br /> ➢ Does parcel require a Survey? Yes No <br /> ➢ Permit application fees submitted? Amount S U U Receipt# �� a <br /> n <br /> a <br /> Reconciles With Real Property Listeres No Date: <br /> a <br /> 7t7 b <br /> If not, explain: 6� <br /> o <br /> a <br /> V <br /> 1 <br /> Application A;77/ <br /> Denied Reason for Denial: <br /> 6\ <br /> Land Use: 0 Date: <br /> 2/18/2003 <br />