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Date ;oIRVW Application No. <br /> T <br /> Subdivision - 4n_z f�,� ti ,,_._,�%T, i0/n7zvQ <br /> The following item(s) (does, does not) conform with the requirements of the <br /> Burnett County Subdivision 'Regulations. Those items not conforming are <br /> explained on the attached page. <br /> Does Does Not Not Applicable <br /> 1. Submitted within 12 months of preliminary <br /> approval <br /> 2. tl Conforms to preliminary plat and incorporates <br /> suggested changes .. <br /> 3. Name of subdivision <br /> 4. Ptoper scale <br /> 5. r Date and North Point <br /> 6. V Locational Description <br /> 7. Name and addregs of owner, surveyor and <br /> engineer <br /> 8. v Accurate survey data-seconds; lineal dimensions <br /> to hundreths of feet; radiii; internal angles; <br /> points of curvature; tangent bearing; lengths of <br /> arcs; lengths of cords. <br /> 9. v Bearings and distances to permanent monuments <br /> le. ri Name, location, width, and centerline of streets <br /> 11 . i Lot' numbers and dimensions <br /> .12. v Location and description of monuments <br /> 13. L— Building setback lines <br /> 14. — Parks and open space and proper dedications <br /> 15. Final improvement plans <br /> 16. Installation or guarantee of installation of <br /> improvements <br /> 17. - Required final certifications <br /> / Signature <br /> A . �Cc� Title/Position <br />